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Paper Information

Journal:   ARCHIVES OF IRANIAN MEDICINE   APRIL 2013 , Volume 16 , Number 4; Page(s) 246 To 248.
 
Paper: 

SURGICAL MANAGEMENT OF A RARE FORM OF CERVICAL DYSGENESIS WITH NORMAL VAGINA, NORMAL VAGINAL PORTION OF THE CERVIX AND OBSTRUCTED UTERUS

 
DOI: 

013164/AIM.0012

 
Author(s):  PARSANEZHAD MOHAMMAD EBRAHIM, NAMAVAR JAHROMI BAHIA*, SALARIAN LEILA, PARSA NEZHAD MARYAM
 
* INFERTILITY RESEARCH CENTER, DIVISION OF REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, SCHOOL OF MEDICINE, SHIRAZ UNIVERSITY OF MEDICAL SCIENCES, SHIRAZ, IRAN
 
Abstract: 

This case was an extremely rare form of cervical dysgenesis that presented with cyclic pain. Diagnostic laparoscopy and vaginoscopy showed the presence of a blind uterus at the level of the internal cervical os with a normal vagina and exocervix. Mullerian ducts are the embryologic origin for the uterus, cervix and upper part of the vagina. Mullerian duct migration initiates from the upper part of the Mullerian system. Therefore an obstructed uterus is usually associated with cervical and upper vaginal anomalies. This case was unusual because of the presence of an isolated segmental atresia at the level of the internal cervical os. However the vaginal portion of the cervix, vagina and urinary system were normal. We theorized that the absence of an appropriate fusion between the Mullerian duct and its underlying mesoderm, loss of cell-to-cell communication and special gene expression during a critical time period or a vascular accident between 12–22 weeks of gestation might have caused this anomaly. The patient underwent a laparotomy to create a utero-cervical canal using a peritoneal graft.

 
Keyword(s): MULLERIAN APLASIA/DYSGENESIS, MULLERIAN DUCTS/ABNORMALITIES, UTERINE CERVIX
 
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