Abstract :
Primary spontaneous colporrhexis is rare a condition characterised by rupture of the upper one third of the
vaginal wall without extension from uterus or cervix in a parous women with an unscarred uterus. In our
case the colporrhexis was also a complete one with rupture of the entire vaginal wall layers.
A 31-year old, second gravida was booked in our hospital at 36 wks of gestation. She had no comorbities.
She had previous full term normal vaginal delivery of an alive baby weighing 2.75kg.
At 39 weeks and 4 days gestation she was admitted for induction of labour as she had borderline liquor.
Induction was done with 2 doses of misoprostol 25mcg kept vaginally 4 hrs apart. 2 hours after placing the
2ndmisoprost she had spontaneous rupture of membranes with clear liquor draining PV.With strong uterine
contractions. She delivered within 45minutes a live healthy baby of 3kg weight. Placenta was delivered by
AMTSL. Bleeding per vagina was within normal limits. During visualization of cervix and vagina prior
to closure of episiotomy, omentum was seen coming out of upper part of posterior fornix of vagina. An
irregular transverse rent was found and felt behind the cervix. Cervix was intact Uterus had contracted
well. There was no excessive bleeding from vagina. Patients vitals were stable. Vagina was immediately
packed and patient was shifted to OT after explaining about the unexpected complication and obtaining
informed consent from patient and her relatives.
Under anaesthesia, Visualisation of cervix and Examination of uterus was done. They were found to be
intact. No extension of episiotomy seen. There was a transtransverse tear of 5 cm involving the posterior
fornix. The left edge of the tear was found to be extending slightly upwards for about 2 cm. Omentum was
seen protruding through the rent. The edges were dilineated, omentum was pushed inside. The delineated
edges of the rent were sutured with 1-0 vicryl with intermittent sutures in two layers. Complete hemostasis
was ensured.
Keyword :
Colporrhexis.