Vaginal Synechiae in a Pregnant Woman with Past Surgery of Low Septum Resection: A Case Report

Abstract

Introduction: Transverse vaginal septum is a rare mullerian anomaly. Patients with a complete transverse vaginal septum are diagnosed during menarche with symptoms of abdominal pain and amenorrhea. Here, we present a patient who underwent septal resection during puberty and was referred in pregnancy due to vaginal synechiae. Case presentation: The patient was a 40-year-old primigravid referred to the maternity department at 39 weeks of gestational age with labor pain and inability to perform a vaginal examination. She had a past surgical history of low vaginal septum at 13 years old. The vagina was completely obstructed. A thorough resection of the synechiae was performed along with a cesarean section to create a drainage path. Conclusion: It is important to consider a pregnant woman's history of Müllerian abnormalities. In these patients, due to the low frequency of intercourse and the conditions of progesterone dominance, there is a possibility of re-stenosis and the imposition of cesarean section. Paying attention to this possible complication and preventing it by using a dilator can be helpful.