Post Coital Vaginal Tear - A Rare Life Threatening Emergency

Abstract

Post coital vaginal tear or rupture is a well known entity to the gynecologist .Coitusinduced vaginal tear in a parous woman with no prior pelvic surgery or other risk factors is a rare clinical presentation. Here we present a case of Post coital vaginal tear which presented as a life threatening emergency. INTRODUCTION: Non obstetric vaginal lacerations differ greatly from lacerations sustained during childbirth and are generally classified into two types. The first type is relatively minor and is associated with normal sexual intercourse. These lacerations usually resolve with minimal treatment. The second type of laceration is deeper and more extensive, often resulting in significant vaginal bleeding. This condition can be life threatening and requires immediate intervention CASE PRESENTATION: Mrs. XX, 30 years old lady, P2L2, presented with the complaints of excessive bleeding per vagina since 4 hours to emergency OBG ward at night. She gives h/o passage of clots and had changed about 3 to 4 clothes which was fully soaked .Her previous menstrual cycles were regular 3-4 days/30 days LMP: day 1. She had both FTND at government hospital, P1-male 9 years, p2-female 6 years. She had undergone laparoscopic sterilization 6 year back. On General physical examination-she was moderately built and nourished and severely anaemic. Her Pulse rate was 120 bpm, feeble, low volume, and BP-systolic was 80 mm Hg, Her tongue was dry , extremities were cold, and tachypnea-20/min was present. Per Abdomen Examination was soft and non tender, and there was no organomegaly. Per Speculum examination revealed an Annular tear about 4 cm present at the cervicovaginal junction posterolaterally on the right side. On Bimanual examination Uterus was anteverted, normal in size, firm, mobile, fornices free and non tender.