Successful spontaneous pregnancy in a nullipara with acquired gynaetresia: A case report

Background: Gynaetresia is the narrowing or complete occlusion of the vagina which may be congenital or acquired. Acquired gynaetresia is commoner in Nigeria due to female genital mutilation and vaginal insertion of herbs. Gynaetresia is a public health issue that requires a great attention to prevent all its associated morbidities. Objective: To report a case of nullipara with acquired gynaetresia that presented in labour. Methods: The case note of the patient and how she was managed were reviewed. Relevant review of the literature on the subject was also done. Results: She was a 24 year old Primary Health Care (PHC) booked Gravida 3 Para 0+2, a trader with secondary level of education who presented in labour ward of Rivers State University Teaching Hospital (RSUTH) at an unknown gestation. She was referred from the PHC on account of labour pains of 6 hours duration and a dense fibrotic tissue sealing off most of the vaginal wall. There was a history of passage of herbal concoction in her vagina 14 months prior to presentation to induce abortion. She had emergency lower segment Caesarean Section (C/S) and outcome was a live male baby who weighed 3kg with a good APGAR score. She did well post operatively, was counseled for vaginoplasty and discharged home with her baby on the 5thpost-operative day in good clinical state. Conclusion: Acquired gynaetresia due to vaginal insertion of herbal pessaries is a preventable condition if only our women in this part of the world are made to understand the significance and implications of this act. This is by educating the public on the morbidities associated with this condition