This clinical report deals with the management of obstructive vaginal transverse septum at an early stage and conservative management of the same with canalization along with the help of hollow cervical stent.
ABSTRACT Introduction Risk of uterine rupture in obstructed labor in grand multipara in developing countries is well documented; however, rupture of vagina involving bladder is uncommon. Below is described a rare case of 30-year-old grand multipara who suffered vaginal rupture associated with bladder rupture rather than uterine rupture during second stage of labor. This case is an important reminder to obstetricians that vaginal rupture can also occur in unscarred uterus without uterine involvement. How to cite this article Garg R, Singh S, Yadav A, Kumar A, Sahu S, Agarwal R. Vaginal and Bladder Rupture without Uterine Rupture in Unscarred Uterus. J South Asian Feder Obst Gynae 2017;9(3):269-270.
ABSTRACT Aim To differentiate nonclassical congenital adrenal hyperplasia (NCAH) from polycystic ovarian syndrome (PCOS) in a 13-year-old girl. Background Hirsutism and virilization are effects of hyperandrogenism by ovaries and adrenal glands. It has a marked psychological and social impact affecting the quality of life; 75% of premenarchal girl have hyperandrogenism, which is due to PCOS but late-onset congenital adrenal hyperplasia cannot be ruled out, and this leaves the clinician in quandary regarding the diagnosis and management. Case report A 13½-year-old girl presented with excessive facial hair, hoarseness of voice, and darkening of elbow pits since past 2 months, which was increasing in severity. The patient had not yet attained menarche but had pubarche 1 year back. Examination revealed presence of acanthosis, underdeveloped breasts, and clitoromegaly >3 cm. Levels of 17-hydroxyprogesterone were normal but higher levels were reported poststimulation. Fasting insulin levels were also high. Appropriate treatment was started, which led to improvement in patient's symptoms. Conclusion There is significant overlapping between PCOS and NCAH, which warrants accurate diagnosis based on hormonal analysis to institute early and appropriate therapy. Significance Early therapy can prevent infertility and androgenic complications later in life. How to cite this article Jain P, Bhalerao AV, Aggarwal S. Late-onset Congenital Adrenal Hyperplasia or Early-onset Polycystic Ovarian Syndrome: A Clinical Dilemma. J South Asian Feder Obst Gynae 2017;9(3):280-282.
