Imperforate Hymen: A Report of a Case With Classical Signs

An imperforate hymen (IH) is a condition where the hymen, which is a thin membrane that partially covers the vaginal opening, completely obstructs the vaginal canal. This condition is associated with problems such as pelvic mass, cyclical abdominal discomfort, and difficulty in urination. The occurrence of IH is quite rare, with an incidence of only one in 1000-10,000 women worldwide. We discuss a classical case of primary amenorrhoea with associated complaints of urinary retention and its management by hymenotomy (cruciate incision). We also considered the risk of hymen re-closure due to the lack of estrogenization of genital tissue and offered the patient the option of vaginal molding.

Uterine Artery Embolisation: A Saviour for Central Placenta Previa

Central placenta previa is generally managed by caesarean section, uterotonic drugs, hemostatic sutures, and hemostatic balloon tamponade, and it usually ends in peripartum hysterectomy, with an incidence of 4% along with an increased incidence of maternal and neonatal morbidity or mortality. Selective uterine artery embolization (UAE) helps to prevent these complications while preserving future fertility. A 32-year-old patient was diagnosed as a case of a previous section with central placenta previa with accreta at 38 weeks and was planned for an elective caesarean section. A prophylactic selective bilateral internal iliac artery cannulation under sonographic guidance and subsequent cannulation and embolisation of bilateral uterine arteries under fluoroscopic guidance was done. It reduced the massive blood transfusions and operative time, preserved fertility without any maternal or foetal morbidity or mortality, and no other complications were reported.