SPONTANEOUS TERM PREGNANCY IN ANOGENITAL MALFORMATION POST COLOSTOMY (BLIND END VAGINAL SEXUAL INTERCOURSE) Yohanes Iddo Adventa1, Trika Irianta2, Eddy Tiro3, David Lotisna4
1) Resident at Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
2) Staff at Urogynecology and Reconstructive Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
3) Staff at Social Obstetric and Gynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanudin University, Makassar, Indonesia
4) Staff at Urogynecology and Reconstructive Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Abstract
Introduction: The prevalence of female genital tract congenital anomaly is 4% until 7%, including blind end vagina. Hymen and vaginal anomaly could restrict menstruation, sexual activity, fertility, and delivery. Vaginal anomaly is related to other genital tract anomalies and extragenital abnormalities. Preoperative spontaneous pregnancy in blind end vagina is a rare case.
Case: Young married women, 22 years old with Gravida 1 Para 0 Abortus 0 had term pregnancy by blind and vaginal sexual intercourse. During the second day of her life, she had a repair of atresia ani and structure occurred. The patient had defecation difficulty during her life and had a limited diet. After her marriage, vaginal agenesis was diagnosed and imaging examination showed a vesicovaginal fistula with ectopic vagina opening into the lumen of rectum. 6 months before pregnancy, a colostomy procedure was performed to improve quailty of life. Caesarean section delivery at term was performed at emergency theatre with no complication due to uterine contractions. A healthy female baby was delivered with normal anatomy. Informed choice and education had been delivered to the patient for vaginal reconstruction and the patient chose to delay the procedure because of previous normal spontaneous pregnancy.
Result: Pelvic examination is mandatory for vaginal anomaly diagnosis. Imaging modalities can explore other genital or extragenital abnormalities related to blind end vagina. Reconstruction management can be offered to improve the quality of life.
Conclusion: Management such as anomalies depends on patient preferences since spontaneous pregnancy occurred by unusual sexual intercourse. Caesarean delivery is the only preferable management in pregnancy in blind end vagina case
Keywords: blind end vagina, vaginal anomaly, spontaneous pregnancy, fistula
