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剖宫产术后发生的继发性阴道闭锁:一种未报道的情况。

Secondary vaginal atresia following caesarean section: an unreported entity.

机构信息

Obstetrics and Gynaecology, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India.

Obstetrics and Gynaecology, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India

出版信息

BMJ Case Rep. 2021 Feb 23;14(2):e238427. doi: 10.1136/bcr-2020-238427.

Abstract

Postpartum genital tract adhesions are infrequent and exact incidence is not reported. Severe dystocia, obstructed labour and frequent pelvic examinations have been proposed as possible causes of vaginal adhesion following vaginal delivery. Atresia/adhesions of vagina following caesarean section is very rare. Here, we report a rare case of 21-year-old P1L1 woman presenting with secondary amenorrhoea associated with cyclical abdominal pain following caesarean section. Per speculum examination showed a blind vagina with no communication with the upper one-third. We created a neovagina after adhesiolysis. We hope to increase the awareness of the obstetricians around the globe about postpartum genital tract adhesion, which may even occur as a rare secondary complication of caesarean section. We also wish to bring to the light of obstetricians that numerous pelvic examinations or difficult vaginal delivery may lead to genital tract trauma, and thus, must be minimised in an attempt to prevent postpartum genital tract adhesions.

摘要

产后生殖道粘连并不常见,确切的发病率也没有报道。严重的难产、梗阻性分娩和频繁的盆腔检查被认为是阴道分娩后发生阴道粘连的可能原因。剖宫产术后阴道闭锁/粘连非常罕见。在这里,我们报告了 1 例罕见的病例,患者为 21 岁 P1L1 女性,在剖宫产术后出现继发性闭经,并伴有周期性腹痛。阴道镜检查显示盲阴道,与上三分之一没有相通。我们在粘连松解后形成了一个新的阴道。我们希望提高全球妇产科医生对产后生殖道粘连的认识,即使它可能是剖宫产的罕见继发性并发症。我们还希望让妇产科医生注意到,大量的盆腔检查或困难的阴道分娩可能导致生殖道创伤,因此,必须尽量减少,以试图预防产后生殖道粘连。

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本文引用的文献

2
Vaginal adhesions in a woman with the history of dystocia.有难产病史女性的阴道粘连。
Obstet Gynecol Sci. 2014 Jan;57(1):70-2. doi: 10.5468/ogs.2014.57.1.70. Epub 2014 Jan 16.
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Postpartum labial adhesions.产后阴唇粘连
J Am Board Fam Med. 2007 Jul-Aug;20(4):408-10. doi: 10.3122/jabfm.2007.04.060214.
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Postpartum labial adhesions following normal vaginal delivery.
J Obstet Gynaecol. 2005 Feb;25(2):215. doi: 10.1080/01443610500051262.

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