Congenital defects of female generative organs development. Lecturer : Antonova G. A. Assistant of Chair of Obstetrics and Gynecolgy SSMU
Task № 1. A girl of 14 years old was brought авлена to gynecological department with complains on repeated cyclic с painsся pains, sensation of heaviness in low part of abdomen, sometime problems with urination. n
n What are Your questions?
Date of anamnesis of disease: n From 13, 5 years old she has cyclic, repeated pains in low part of abdomen, sometime nausea, vomiting. No menstruation.
Anamnesis of vitae n n She was growing in coordination with age. She had in the past chronic tonsillitis. According to mother ‘s telling , she had such problem, as chronic vulvitis and was treated children’s gynecologist. In present time there is no acute stage of disease.
Date of common examination: Height is 158 sm, mass 56 kg. Right way of body buправильного Built, satisfactory feeding. Breasts are defeloped.
Date of gynecologic examination: n n n Hair growing is on female type. Vulva skin color is pink. There is overloading of hymen. Р. R. There is a large formation in small pelvis, elastic consistence , on the top of it there is a small hard organ.
n Methods of additional examination?
Date of laboratory investigation. Ø Ø Ø CBA – HG level is 132 grl , erythrocytes 3 mln 200 thousand. Leucocytes- 6800 Fibrinogen is 4, 5 gr/ lл Degree of vagina purity is the II , Blood group is В( III) third, Rh+( positive) Normal of urine analysis.
Date of USI: n There is Echo- negative formation in small pelvis.
Provisional diagnosis is : n Atresia of hymen.
Put a differential diagnosis on the base of pictures.
Treatment is : n Dissection of hymen with crest ‘s insision.
What is a an amenorrhea form in this case? n
n On which week of intrauterine development the internal female organs are formated?
Time of formation is n n n From 6 till 20 weeks. Muller’s ducts on the 6 week. From 7 -8 weeks – growing and making together of ducts. There are 2 uterine- vaginal cavity in the beginning, separated by fibrous septum Process of reduction is performing from. caudal to cranial end.
Risk group of defects n From women with professional factors, smoker, drinkers, infection diseases from 8 to 16 weeks, particular virus infections.
Epidemiology n n n Congenital defects take 4% among all types of defects. There is increasing at 10 times quantity of defects During the last 5 years.
1 — атрезия; 2 — аплазия влагалища и матки; 3 — частичная или полная атрезия влагалища; 4 — удвоение влагалища и матки с частичной или полной аплазией одного из влагалищ.
There are such congenital defects , as: n n n n n 1. Agenesia 2. Aplasia 3. Hypoplasia 4. Hyperplasia 5. Heterotopy 6. Hetroplasia 7. Ectopy 8. Multyplication 9. Atresia 10. Stenosis. Please, give a conception about every.