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Obstetrics and gynaecology
Impact of luteoma during pregnancy on fetal development and its long-term effects into adulthood
  1. Ioanna Mavrantoni1,
  2. Rebecca Borneman2,
  3. Adam B Hittelman3 and
  4. Alla Vash-Margita4
  1. 1Gastroenterology, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
  2. 2Obstetrics and Gynaecology, Yale New Haven Hospital, New Haven, Connecticut, USA
  3. 3Yale New Haven Hospital, New Haven, Connecticut, USA
  4. 4Section of Pediatrics and Adolescent Gynecology; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to Dr Alla Vash-Margita; alla.vash-margita{at}yale.edu

Abstract

A woman in her 30s presents to the Differences in Sexual Development Programme at a tertiary care academic medical centre with vaginal stenosis and scarring. Her medical history is significant for virilisation in utero due to a maternal luteoma of pregnancy. Laboratory investigations at the time of birth showed elevated androgens in both mother and daughter. During infancy, she underwent clitoroplasty and vaginoplasty for correction of posterior vaginal fusion. She represented as an adult with vaginal stenosis, with associated physical and psychosocial implications. She was not able to insert a tampon or have penetrative intercourse. After examination and shared decision-making, the patient underwent cystoscopy, vaginoscopy and posterior vaginoplasty with the goal to create a normal calibre vagina. Postoperative dilator use was recommended to prevent restenosis of the introitus. In clinic follow-up, the patient was observed to have a normal calibre vagina.

  • Pregnancy
  • Obstetrics, gynaecology and fertility
  • Urinary and genital tract disorders
  • Estrogens
  • Gynecological cancer

https://doi.org/10.1136/bcr-2023-259373

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: IM, RB and AV-M. The following authors gave final approval of the manuscript: AV-M, ABH and RB.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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