关键词: Ectrodactyly Herlyn-Werner-Wunderlich syndrome (HWWS) Müllerian duct anomalies OHVIRA syndrome Obstructed hemivagina Pregnancy Renal agenesis Utero didelphys

Mesh : Abdominal Abscess / diagnosis etiology therapy Abnormalities, Multiple Adult Breech Presentation / surgery Cesarean Section / adverse effects methods Congenital Abnormalities / diagnosis Female Fetal Membranes, Premature Rupture / surgery Gynecologic Surgical Procedures / methods Humans Kidney / abnormalities Kidney Diseases / congenital diagnosis Limb Deformities, Congenital / diagnosis Patient Care Management / methods Pregnancy Pregnancy Complications / diagnosis etiology Treatment Outcome Urogenital Abnormalities / diagnosis surgery Uterus / abnormalities Vagina / abnormalities

来  源:   DOI:10.1186/s12884-018-2133-2   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
BACKGROUND: Herlyn-Werner-Wunderlich syndrome (HWWS) is an uncommon congenital anomaly of the female urogenital tract, characterised by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. We reported the difficult pregnancy course complicated by an extremely rare and unique case of this syndrome associated with ectrodactyly, a clinical combination never described in literature.
METHODS: A 28- year-old nulliparous woman previously diagnosed for HWWS associated with ectrodactyly of the right foot and with a history of abdominal left hemi-hysterectomy, ipsilateral salpingectomy, vaginal reconstruction when she was an adolescent. She suffered from threats of abortion in the first trimester, recurrent urinary tract infections during all pregnancy. At 33 weeks + 5 days of gestational age, she was hospitalized for premature rupture of the membranes and uterine contractions and a caesarean section was performed because of breech presentation. Postpartum period was complicated by a pelvic abscess resolved with parental antibiotic therapies.
CONCLUSIONS: Our literature review shows an unusual aspect in our case: HWWS is not classically associated with skeletal anomalies. Moreover, the most frequent urogenital side affected is the right, not left side as in this woman. Preterm spontaneous rupture of membranes and fetal abnormal presentation represent frequent complications and probably post-caesarean infections are related to pregnancies in the context of this syndrome.
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