A Case of OHVIRA (Obstructed Hemivagina and Ipsilateral Renal Anomaly) Syndrome Diagnosed After Signs of Infection During Pregnancy.

Abstract

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is a rare group of disorders that affects women at all stages of life. These disorders can elicit symptoms such as menstrual molimina and dysmenorrhea during puberty; miscarriage, premature birth, and infertility during childbearing age; and purulent discharge during menopause and old age. In this study, we report our experience with OHVIRA syndrome, which was diagnosed during childbearing age when the patient showed signs of infection during pregnancy. The patient was a 28-year-old female diagnosed with OHVIRA syndrome during pregnancy who had previously undergone a cesarean section. Despite having a normal prenatal period, the patient experienced lower abdominal pain at 27 weeks gestation, prompting urgent hospitalization. Clinical signs suggested chorioamnionitis; however, the amniocentesis results were negative. Computed tomography and magnetic resonance imaging demonstrated unilateral renal agenesis and a duplicated uterus, characteristics of OHVIRA syndrome, in addition to a uterine infection on the non-pregnant side. Antibiotic treatment enabled the pregnancy to continue until an emergency cesarean section was performed at 31 weeks. Surgery confirmed OHVIRA syndrome with incomplete obstruction. This case highlights the challenges that can arise during the perinatal period due to a partially obstructed duplicated uterus. It emphasizes the importance of performing ultrasonographic renal evaluations when assessing uterine malformations, as this can aid in early detection and effective management of women's health, especially during the perinatal period. Despite its rarity, it is crucial for healthcare providers to be aware of OHVIRA syndrome during clinical interventions.