Distortion of the Cervico-Vaginal Angle—A Cause of Secondary Infertility

Abstract

Background: A case of a 27-year-old G1P0 Education graduate who became secondarily infertile because of the distortion of the cervico-vaginal angle as a result of adherence of the body of the uterus to the anterior abdominal wall. Aim: The aim of this article is to raise awareness and a high index of suspicion in patients who earlier had a classical caesarian section that presented with secondary infertility. Case Presentation: A 27-year-old G1P0 graduate presented at the Faith Foundation Specialist Clinic, Calabar with secondary infertility. She previously had an emergency classical Caesarian Section for an obstructed labour in an apparent attempt to serve the baby’s life. The body of the uterus became adherent to the anterior abdominal wall thus distorting the angulation of the cervix and vagina. Available investigation that was done revealed no abnormality with the husband, but in the cause of further investigations she developed signs and symptoms of acute appendicitis for which she was operated. The access was through the midline incision in the anterior abdominal wall where it was discovered that the uterine body was adherence to the anterior abdominal wall. This was released and placed in the pelvis. Subsequently, she became pregnant and was delivered. Conclusion: Classical approaches in Caesarian Sections are rarely used nowadays. The Surgeon/Gynaecologist should be conscious of the possibility of the uterine body adherence to the anterior abdominal wall when cases involving secondary infertility present.