Two successful pregnancies in Herlyn–Werner–Wunderlich syndrome

Cozzolino, Mauro; Corioni, Serena; Malosso, Elena Rita Magro; Sorbi, Flavia; Mecacci, Federico

doi:10.3109/01443615.2014.914898

Cited by 7 publications

(12 citation statements)

References 10 publications

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“…No obstante, en estas pacientes se ha documentado un mayor riesgo de parto prematuro, ruptura prematura de membranas, retraso del crecimiento fetal y mala presentación del feto al momento del parto (15,28). Un útero didelfo no es indicación de parto por cesárea si no hay obstrucción del canal (29), además los embarazos en el lado de la obstrucción no son frecuentes (30). Finalmente, debe tenerse en cuenta que los exámenes pélvicos en adolescentes o mujeres virginales pueden estar significativamente limitados (15).…”

Section: Discussionunclassified

Síndrome de Herlyn-Werner-Wunderlich. Reporte de caso

Alza¹,

Mesa-Espinel²

2021

Rev. Fac. Med.

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Introducción. El síndrome de Herlyn-Werner-Wunderlich (SHWW) es una malformación congénita rara del tracto urogenital que se caracteriza por la triada útero didelfo, hemivagina obstruida y anomalía renal ipsilateral, y que suele diagnosticarse después de la menarquia. Su tratamiento consiste en resección del tabique vaginal y drenaje de la hemivagina obstruida, con un buen pronóstico postquirúrgico. Presentación del caso. Mujer de 22 años con un cuadro clínico de 9 años de evolución que inició cuando tuvo su primera menstruación, consistente en dismenorrea, dolor pélvico y ciclos menstruales irregulares, quien asistió al servicio de ginecología de un hospital de segundo nivel en Sogamoso, Boyacá (Colombia). La paciente reportó haber visitado múltiples especialistas y recibido tratamiento con vitamina E, metformina y anticonceptivos, sin mejoría de los síntomas y signos. Luego de ser valorada, y teniendo en cuenta los hallazgos en ecografía y resonancia magnética, fue diagnosticada con SHWW, por lo que se le realizó colpotomía más resección de masa paracervical derecha de aproximadamente 60x60 mm y de tabique vaginal, lográndose la resolución completa de los síntomas. Finalmente, 10 meses después de la cirugía, la joven refirió encontrarse en estado de embarazo, sin presentar complicaciones. Conclusión. El SHWW es una malformación poco común que debe considerarse como diagnóstico diferencial en mujeres de cualquier edad con anomalías de los conductos paramesonéfricos, dolor pélvico, dismenorrea y masa en el tracto genital, pues su diagnóstico temprano y un tratamiento oportuno mejoran considerablemente la calidad de vida de estas pacientes al reducir la severidad de los síntomas, disminuir la incidencia de complicaciones y mejorar el pronóstico obstétrico.

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Section: Discussionunclassified

Síndrome de Herlyn-Werner-Wunderlich. Reporte de caso

Alza¹,

Mesa-Espinel²

2021

Rev. Fac. Med.

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“…These may consist of conservative treatments like the desobstruction of hemivagina, the therapeutic drainage of hematocolpos, the vaginal septotomy and marsupialization; or less conservative interventions like laparoscopic hemi-hysterectomy associated or not with ipsilateral salpingectomy [25–28]. The best treatment of HWWS is controversial but most of the authors conclude that an explorative laparoscopy with vaginal septotomy and drainage of hematocolpos is enough to restore the functionality of both part of the uterus, avoiding hemi-hysterectomy [29, 30]. However, HWWS has good obstetric prognosis: 87% of pregnancy rate [27], approximately 62% positive obstetric outcomes without complications during delivery [5, 7].…”

Section: Discussionmentioning

confidence: 99%

“…This rate is higher than that of the general population (9-10%). Instead the caesarean sections rate is 84% and it reflects the high incidence of the breech presentation (51%) [29, 32]. In the presentation of this case we drew attention to its rarity because it involves the left part of the body, while usually is the right side affected [28, 33, 34] and the association with a malformation of the skeleton of the lower limbs, ectrodactyly of the right foot, was not ever been reported in literature; we found only a case report which described the combination of HWWS and lumbar scoliosis [35] and we are not sure if the skeletal involvement could be only an incidental finding.…”

Section: Discussionmentioning

confidence: 99%

Successful preterm pregnancy in a rare variation of Herlyn-Werner-Wunderlich syndrome: a case report

Cappello

Piccolo

Cucinelli

et al. 2018

BMC Pregnancy Childbirth

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BackgroundHerlyn–Werner-Wunderlich syndrome (HWWS) is an uncommon congenital anomaly of the female urogenital tract, characterised by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. We reported the difficult pregnancy course complicated by an extremely rare and unique case of this syndrome associated with ectrodactyly, a clinical combination never described in literature.Case presentationA 28- year-old nulliparous woman previously diagnosed for HWWS associated with ectrodactyly of the right foot and with a history of abdominal left hemi-hysterectomy, ipsilateral salpingectomy, vaginal reconstruction when she was an adolescent. She suffered from threats of abortion in the first trimester, recurrent urinary tract infections during all pregnancy. At 33 weeks + 5 days of gestational age, she was hospitalized for premature rupture of the membranes and uterine contractions and a caesarean section was performed because of breech presentation. Postpartum period was complicated by a pelvic abscess resolved with parental antibiotic therapies.ConclusionsOur literature review shows an unusual aspect in our case: HWWS is not classically associated with skeletal anomalies. Moreover, the most frequent urogenital side affected is the right, not left side as in this woman. Preterm spontaneous rupture of membranes and fetal abnormal presentation represent frequent complications and probably post-caesarean infections are related to pregnancies in the context of this syndrome.

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“…[ 6 ] Although fertility is not impaired and the fetal survival rate is high, premature rupture of fetal membranes and delayed fetal development are still causes for concern. [ 11 ] Therefore, when unilateral renal agenesis and uterus didelphys coexist, the first thing to consider and rule out is the presence of a blind vagina.…”

Section: Discussionmentioning

confidence: 99%

A case report on Herlyn–Werner–Wunderlich syndrome with spontaneous abortion

et al. 2018

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Introduction:Herlyn–Werner–Wunderlich syndrome (HWWS) is a rare congenital abnormality of the urogenital tract characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. It is usually diagnosed after menarche, with a clinical presentation of dysmenorrhea, recurrent abdominal pain, and irregular menses. However, it is rare to diagnose it during pregnancy, subsequently resulting in spontaneous abortion.Case presentation:A 22-year-old Chinese woman with HWWS whose left uterine pregnancy underwent spontaneous abortion presented with a right perforated obstructed hemivagina and right renal agenesis. The right vaginal septum was resected and the hematocolpos was drained, thereby relieving lower abdominal pain and preserving future fertility.Conclusion:Co-presentation of unilateral renal agenesis and uterus didelphys should encourage clinicians to rule out HWWS. Early diagnosis and subsequent treatment can avoid possible serious complications.

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Two successful pregnancies in Herlyn–Werner–Wunderlich syndrome

Cited by 7 publications

References 10 publications

Síndrome de Herlyn-Werner-Wunderlich. Reporte de caso

Síndrome de Herlyn-Werner-Wunderlich. Reporte de caso

Successful preterm pregnancy in a rare variation of Herlyn-Werner-Wunderlich syndrome: a case report

A case report on Herlyn–Werner–Wunderlich syndrome with spontaneous abortion

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