Failure of prostaglandin induction in an obstructive mullerian abnormality

Article Abstract:

A uterine abnormality may play a part in the failure of prostaglandins to induce labor. A 26-year-old woman who had previously delivered three children vaginally was admitted to a hospital for decreased fetal movement at 24 weeks' gestation. On examination, uterine size was consistent with gestational age and the cervix was closed and firm. An ultrasound revealed fetal death. Labor was to be induced with prostaglandin (PGE) suppositories: PGE2 followed by PGF2alpha. PGE2 vaginal suppositories of 20 milligrams were administered every three hours. No change in the cervix and no uterine contractions occurred within 24 hours. PGF2alpha was then administered intramuscularly for another 24 hours. No changes occurred in the cervix or uterus. Surgery to remove the fetus found that the pregnancy was located in a rudimentary portion of the uterus that was not attached to the cervix or vagina. It was attached only by thin tissue to the right side of the uterus. Because labor was not induced by the prostaglandins, it would appear that the cervix and the uterus are both necessary to the process of labor.

Complications and side effects, Prostaglandins, Labor, Induced (Obstetrics), Induced labor

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Intravaginal foreign body of long duration: a case report

Article Abstract:

Practitioners should consider that a foreign object may be present in the vagina if a patient has chronic, foul-smelling or bloody discharge. A 22-year-old woman with pelvic pain and foul-smelling discharge for more than four years had never been pregnant and denied any sexual activity. A laparotomy had been performed two years earlier but had failed to find a cause of the pain and discharge. On pelvic exam, no normal cervix was seen. Bimanual examination indicated that there was a firm mass in the left pelvis. An ultrasound revealed an enlarged cervix. Magnetic resonance imaging detected the presence of a cylindrical object high in the vaginal canal. The patient denied any knowledge of the object. During surgery a plastic cup-like object filled with necrotic tissue was removed. Scar tissue had developed around the object in the upper vagina.

Diagnosis, Magnetic resonance imaging, Vagina, Foreign bodies (Medical care), Foreign bodies

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Obstructive Mullerian anomalies: case report, diagnosis, and management

Article Abstract:

The case of a 17-year-old woman with a birth defect called uterus didelphys is described. In this condition, the woman has two uteruses and two vaginas, one of which may be blocked by a wall of tissue. This can cause abnormal menstrual bleeding.

Case studies, Causes of, Birth defects, Menstruation disorders

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