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Innovating the conservative management of isolated cervical aplasia
  1. Rafaela Pires1,
  2. Ana Raquel Neves2,3,
  3. Fernanda Geraldes1 and
  4. Fernanda Águas1
  1. 1Department of Gynaecology, Coimbra Hospital and University Centre, Coimbra, Portugal
  2. 2Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Catalunya, Spain
  3. 3Faculty of Medicine, Autonomous University of Barcelona, Barcelona, Spain
  1. Correspondence to Dr Rafaela Pires; rafaelabilpires{at}gmail.com

Abstract

Isolated cervical aplasia (ESHRE/ESGE U0C4V0) is a rare condition with an incidence of approximately 1:100,000 births.

This congenital malformation of the female genital tract represents an impairment of the outflow tract and is an inevitable cause of infertility. Patients usually present with pelvic pain or haematometra and surgical treatment is needed. Conservative management is the first line of approach, allowing for future fertility. However, complications are not negligible. Choosing the best surgical technique remains controversial as few follow-up studies have been published.

We describe a case report of isolated cervical aplasia diagnosed in a 16-year-old patient, managed by a canalisation procedure using a Foley catheter. Following failure of this approach, a levonorgestrel intrauterine system was inserted, which remained efficient after 4 years.

This case adds to the few reports of success in the management of this challenging clinical entity and might guide clinicians to avoid non-conservative approaches in young patients.

  • obstetrics and gynaecology
  • congenital disorders
  • sexual health

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Footnotes

  • Contributors RP was the lead author of this case report, involved in the patient management, especially in initial care and diagnosis. ARN was a key contributor for the manuscript and clinical revision of the gynaecological aspects of the case. FG, as the referral doctor of the patient, and FA, as head of the department, have been actively involved in the decision-making process and present in every step of the patient treatment. All authors revised and approved the final version published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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