Spontaneous Pregnancy in Postoperative Microperforated Hymen: A Case Report

Pribakti Budinurdjaja, Ihya Ridlo Nizomy, Inas Tsurayya Fauziah Lahdimawan
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Abstract

Abstract: Female genital tract anomalies have important effects on reproductive function, and usually recognized after puberty. The membrane canalization process end to various hymenal forms. Microperforate hymen appears as a partial obstruction depending on its  size. Most often, patient will present with menstrual disorders, dyspareunia, and infertility. The aim of this research was to report a case of spontaneous pregnancy in postoperative microperforated hymen in form of case report. A 27-year-old woman, P0A0, complained of pain during intercouse. Patient had been married for 1,5 years, had reguler menstrual cycles without any contraceptive method, but not conceived yet. Inspection showed an obstructed vaginal introitus with a small opening laterally at 3 o’clock, consistent witn microperforate hymen. During surgery, short vaginal introitus was observed and no vaginal canal was seen. A sound was inserted through a small opening of 1 mm in diameter laterally at 3 o'clock, followed by sufficient incision and excision of the distal vaginal tissue. Interrupted suture of the proximal and distal mucosa was performed. The vaginal portion as well as uterus appeared normal. Postoperative tissue healing was good. A spontaneous pregnancy occurred 56 days after the surgery and a healthy term baby was born by caesarean section. In the case of microperforated hymen, menstrual flow can be normal. The patient complained of dyspareunia or impaired sexual penetration leading to infertility, although the presence of a small opening may allow passage of sperm and spontaneous pregnancy may occur before the surgery. Surgery can reduce psychological stress and improve reproductive function, allowing pregnancy to occur. Keywords:Abstract: Female genital tract anomalies have important effects on reproductive function, and usually recognized after puberty. The membrane canalization process end to various hymenal forms. Microperforate hymen appears as a partial obstruction depending on its  size. Most often, patient will present with menstrual disorders, dyspareunia, and infertility. The aim of this research was to report a case of spontaneous pregnancy in postoperative microperforated hymen in form of case report. A 27-year-old woman, P0A0, complained of pain during intercouse. Patient had been married for 1,5 years, had reguler menstrual cycles without any contraceptive method, but not conceived yet. Inspection showed an obstructed vaginal introitus with a small opening laterally at 3 o’clock, consistent witn microperforate hymen. During surgery, short vaginal introitus was observed and no vaginal canal was seen. A sound was inserted through a small opening of 1 mm in diameter laterally at 3 o'clock, followed by sufficient incision and excision of the distal vaginal tissue. Interrupted suture of the proximal and distal mucosa was performed. The vaginal portion as well as uterus appeared normal. Postoperative tissue healing was good. A spontaneous pregnancy occurred 56 days after the surgery and a healthy term baby was born by caesarean section. In the case of microperforated hymen, menstrual flow can be normal. The patient complained of dyspareunia or impaired sexual penetration leading to infertility, although the presence of a small opening may allow passage of sperm and spontaneous pregnancy may occur before the surgery. Surgery can reduce psychological stress and improve reproductive function, allowing pregnancy to occur. Keywords: hymen, microperforate, infertility, spontaneous pregnancy
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微创海门术后自发性妊娠1例报告
摘要:女性生殖道异常对生殖功能有重要影响,通常在青春期后发现。膜通道化过程结束于各种处女膜形式。微穿孔处女膜根据其大小表现为部分阻塞。大多数情况下,患者会出现月经失调、性交困难和不孕。本研究的目的是以病例报告的形式报告一例术后微穿孔处女膜自发性妊娠。一位27岁的女性,P0A0,抱怨肋间疼痛。患者结婚1.5年,月经周期不规律,没有任何避孕方法,但尚未怀孕。检查显示阴道入口阻塞,在3点钟处有一个小的横向开口,与微穿孔处女膜一致。在手术过程中,观察到阴道凹陷较短,未发现阴道管。在3点钟时,通过直径为1mm的小孔横向插入声音,然后充分切开并切除阴道远端组织。对近端和远端粘膜进行间断缝合。阴道部分和子宫看起来都很正常。术后组织愈合良好。手术后56天发生了自然妊娠,剖腹产产下了一个健康的足月婴儿。在处女膜微穿孔的情况下,月经流量可能是正常的。患者抱怨性交困难或性渗透受损导致不孕,尽管存在一个小开口可能会使精子通过,并且可能在手术前发生自然妊娠。手术可以减轻心理压力,改善生殖功能,让怀孕发生。关键词:摘要:女性生殖道异常对生殖功能有重要影响,通常在青春期后发现。膜通道化过程结束于各种处女膜形式。微穿孔处女膜根据其大小表现为部分阻塞。大多数情况下,患者会出现月经失调、性交困难和不孕。本研究的目的是以病例报告的形式报告一例术后微穿孔处女膜自发性妊娠。一位27岁的女性,P0A0,抱怨肋间疼痛。患者结婚1.5年,月经周期不规律,没有任何避孕方法,但尚未怀孕。检查显示阴道入口阻塞,在3点钟处有一个小的横向开口,与微穿孔处女膜一致。在手术过程中,观察到阴道凹陷较短,未发现阴道管。在3点钟时,通过直径为1mm的小孔横向插入声音,然后充分切开并切除阴道远端组织。对近端和远端粘膜进行间断缝合。阴道部分和子宫看起来都很正常。术后组织愈合良好。手术后56天发生了自然妊娠,剖腹产产下了一个健康的足月婴儿。在处女膜微穿孔的情况下,月经流量可能是正常的。患者抱怨性交困难或性渗透受损导致不孕,尽管存在一个小开口可能会使精子通过,并且可能在手术前发生自然妊娠。手术可以减轻心理压力,改善生殖功能,让怀孕发生。关键词:处女膜、微穿孔、不孕不育、自然妊娠
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