Successful Gestation of a Herlyn-Werner-Wunderlich Syndrome Carrier And Patient, After a Hysteroscopic Septoplasty
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Abstract
Introduction: Herlyn-Werner-Wunderlich Syndrome (HWWS) is an embryological malformation that damages the urinary and genital systems. It may have clinical repercussions as progressive dysmenorrhea and compromise the patient’s obstetric future, with occurrence of severe endometriosis and infertility.
Case Report: A patient, 18 years old, admitted for an amniotic fluid loss complaint. She demonstrated a previous diagnosis of HWWS during anamnesis, which was previously discovered and surgically adjusted 4 years earlier, through a hysteroscopic vaginal septoplasty. The patient needed an obstetric admission due to a clinical diagnosis of Prelabor Rupture of Ovular Membranes (PROM), with abdominal delivery after 5 days due to the development of severe preeclampsia. The procedure had no intercurrence, alongside the birth of the conceptus in good clinical conditions.
Discussion: The patients who carry that rare syndrome have didelphys uterus, low genital obstruction and unilateral renal agenesis. When the genital obstruction is complete, the symptoms are often more glaring, producing palpable and painful abdominal mass because of the hematocolpos. Regardless of the anatomic space, the retained flow is susceptible to infections and may cause abdominal sepsis. Furthermore, the patient can acquire infertility for the higher risk of endometriosis or for the anatomic distortions. The cirurgical adjustment is associated with good pregnancy rates and should always be suggested to those patients.
Conclusion: Considering the serious repercussions to the life quality of those patients, the Herlyn-Werner-Wunderlich Syndrome (HWWS) should always be present in differential diagnosis of a specialist doctor’s routine. The premature diagnosis leads to a necessary adjustment and contributes to positive and favorable results in the reproductive life of such patients.
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References
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