http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3191066&dopt=AbstractBritish Journal of Obstetrics and Gynecology. September 1988, Vol. 95,
pp. 933-934
Oral conception. Impregnation via the proximal gastrointestinal tract in
a patient with an aplastic distal vagina. Case report.
Douwe A. A. Verkuyl
Case report
The patient was a 15-year-old girl employed in a local bar. She was
admitted to hospital after a knife fight involving her, a former lover and
a new boyfriend. Who exactly stabbed whom was not quite clear but all
three participants in the small war were admitted with knife injuries.,
The girl had some minor lacerations of the left hand and a single
stab-wound in the upper abdomen. Under general anaesthesia, laparotomy
was performed through an upper midline abdominal incision to reveal two
holes in the stomach. These two woulds had resulted from the single
stab-wound through the abdominal wall. The two defects were repaired in
two layers. The stomach was noted empty at the time of surgery and no
gastric contents were seen in the abdomen. Nevertheless, the abdominal
cavity was lavaged with normal saline before closure. The condition of
the patient improved rapidly following routine postoperative care and she
was discharged home after 10 days. Precisely 278 days later the patient
was admitted again to the hospital with acute, intermittent abdominal
pain. Abdominal examination revealed a term pregnancy with a cephalic
fetal presentation. The uterus was contracting regularly and the fetal
heart was heard. Inspection of the vulva showed no vagina, only a shallow
skin dimple was present below the external urethral meatus and between the
labia minora.
An emergency lower segment caesarian section was performed under spinal
anaesthesia and a live male infant weighing 2800 g was born, with Apgar
scores of 7 and 9 at 1 and 5 minutes, respectively. On exploration,
through the nearly completely dilated cervix, it was found that the normal
uterus ended in a 2 cm deep vagina and that the vagina did not exist more
distally.
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