British Journal of Obstetrics and Gynaecology

Abstract

Oral conception. Impregnation via the proximal gastrointestinal tract in a patient with an aplastic distal vagina. Case report DOUWE A. A. VERKUYL Case report tion was performed under spinal anaesthesia and a live male infant weighing 2800 g was born, with tively. On exploration, through the nearly The patient was a 15-year-old girl employed in a Apgar Scores of 7 and 9 at 1 and 5 min, respec-local bar. She was admitted to hospital after a new Who whom was normal uterus ended in a 2 cm deep vagina and not quite clear but all three participants in the small war were admitted with knife injuries. The The uterus. adnexa and renal tract aooeared knife fight involving her, a former lover and a pletely dilated cervix, it was found that the that the vagina did not exist more distally. girl had some minor lacerations of the left hand and a single stab-wound in the upper abdomen. Under general anaesthesia, laparotomy was per-formed through an upper midline abdominal incision to reveal two holes in the stomach. 'These two wounds had resulted from the single stab-wound through the abdominal wall. The two defects were repaired in two layers. The stomach was noted empty at the time of surgery and no gastric contents were seen in the abdo-men. Nevertheless, the abdominal cavity was lavaged with normal saline before closure. The condition of the patient improved rapidly fol-lowing routine postoperative care and she was discharged home after 10 days. Precisely 278 days later the patient was admitted again to hos-pital with acute, intermittent abdominal pain. Abdominal examination revealed a term preg-nancy with a cephalic fetal presentation. The uterus was contracting regularly and the fetal heart was heard. Inspection of the vulva showed no vagina, only a shallow skin dimple was pres-ent below the external urethral meatus and bctwcen the labia minora. An emergency lower segment caesarean sec-