obsolete Congenital or acquired abnormality of vulva, with delivery

Congenital or Acquired Abnormality of Vulva Complicating Pregnancy, Childbirth, or the Puerperium

A congenital or acquired abnormality of the vulva can complicate pregnancy, childbirth, or the puerperium. This condition is characterized by an abnormal saccular dilatation of lymphatics in the dermal papillae, which can be visible as vesicles clinically.

• The entity may be either acquired or congenital in nature [1].
• This abnormality can occur in conjunction with other pelvic malformations, which are rare conditions characterized by specific common features resulting from an abnormal embryological development [5].

Key Features

• Abnormal saccular dilatation of lymphatics in the dermal papillae
• May be acquired or congenital in nature
• Can occur in conjunction with other pelvic malformations

References

[1] KK Roy, 2006 - This abnormal saccular dilatation of lymphatics occurs in dermal papillae visible as vesicles clinically. The entity may be acquired or congenital. [5] May 27, 2022 - Congenital pelvic malformations are rare conditions characterized by specific common features resulting from an abnormal embryological development.

Congenital Anomalies of the Vulva and Vagina

The signs and symptoms of congenital anomalies of the vulva and vagina can vary depending on the type and severity of the condition. However, some common symptoms include:

• Asymmetric appearance: The vulva may appear uneven or asymmetrical due to the abnormal development of certain tissues [1].
• Enlargement of certain tissues: Some women with congenital anomalies of the vulva may experience enlargement of specific tissues, which can lead to discomfort and other symptoms [1].
• Possible discomfort: Women with these conditions may experience discomfort or pain in the vulvar area due to the abnormal development of tissues [1].

In addition to these symptoms, some women with lower vaginal atresia (a congenital anomaly where the vagina is absent) may experience:

• A small pouch or dimple: A small pouch or dimple may be present where the vaginal opening should be, which can be a sign of this condition [2].
• Absence of menstrual cycle: Women with lower vaginal atresia may not have a menstrual cycle due to the absence of a vagina [10].

It's essential to note that these symptoms can vary depending on the specific congenital anomaly and individual factors. If you suspect you or someone else has a congenital anomaly, it's crucial to consult a healthcare professional for proper diagnosis and treatment.

References:

[1] - Symptoms of congenital anomalies of the vulva include: An asymmetric appearance; Enlargement of certain tissues; Possible discomfort [Context 1]

[2] - Symptoms of lower vaginal atresia include: A small pouch or dimple where the vaginal opening should be [Context 1]

[10] - Symptoms include a small pouch where the vagina should be, absence of a menstrual cycle and lower abdominal pain. Vaginal agenesis requires surgical correction, or having intercourse and a baby may be impossible. Some women may have kidney abnormalities. Congenital anomalies of the cervix [Context 10]

Please note that these conditions are considered obsolete in modern medical practice, and most congenital anomalies can be treated with proper medical care.

Based on the provided context, it appears that you are looking for diagnostic tests related to congenital or acquired abnormalities of the vulva, particularly in relation to pregnancy and delivery.

According to search result [10], a detailed clinical history is essential when evaluating the vulva. This includes being familiar with vulvar anatomy and changes that occur depending on age and hormonal status. A systematic approach should be developed to ensure no parts are left unexamined.

Tests to evaluate for vaginitis, as mentioned in search result [11], include:

• Vaginal pH testing (normal range: 3.8-4.2)
• Saline wet mount
• Potassium hydroxide (KOH) wet mount

These tests can indicate conditions such as bacterial vaginosis and trichomoniasis.

In addition, search result [12] mentions the use of an ultrasound to confirm pregnancy milestones and check for fetal spine and body part defects. This test is also used to diagnose ectopic pregnancies or miscarriages and examine the uterus and pelvic anatomy.

Search result [13] provides information on pregnancy and fetal development, highlighting significant milestones that occur during gestation.

Lastly, search result [14] notes that disorders of the vulva and vagina are common and can cause discomfort. However, it does not provide specific diagnostic tests for these conditions.

It's worth noting that while some search results mention diagnostic tests, they do not specifically address obsolete congenital or acquired abnormalities of the vulva in relation to delivery.

Citations: * [10] - The evaluation of the vulva should always begin with a detailed clinical history. * [11] - Tests to evaluate for vaginitis include vaginal pH testing, saline wet mount, and potassium hydroxide (KOH) wet mount. * [12] - An ultrasound is used to confirm pregnancy milestones and check for fetal spine and body part defects. * [13] - Pregnancy is the state of carrying a developing embryo or fetus.

Based on the provided context, it appears that there are various treatments available for congenital and acquired abnormalities of the vulva.

Treatment Options

• For conditions such as labial adhesions, a provider may prescribe topical creams like conjugated estrogens vaginal cream or corticosteroid cream (betamethasone 0.5%) [6].
• Topical imidazoles (e.g., clotrimazole) have been found to be effective in pregnant women with vulvovaginal candidiasis (VVC), but a longer treatment regimen may be required [7].

Surgical Treatment

• Surgical reconstruction or resection is the main treatment for both congenital and acquired genital tract anomalies, including those affecting the vulva [3].
• In some cases, surgical treatment may be recommended to correct abnormalities such as vaginal agenesis or obstruction [10-12].

Medication

• For conditions that do cause problems with fertility, menstruation, or sexual relations, medication can be effective. However, specific information on drug treatment for vulvar abnormalities is limited in the provided context.

It's essential to consult a healthcare professional for personalized advice and treatment options, as they can assess individual cases and provide guidance on the most suitable course of action.

References:

[3] Surgical reconstruction or resection is the main treatment for both congenital and acquired genital tract anomalies. [6] Topical creams like conjugated estrogens vaginal cream or corticosteroid cream (betamethasone 0.5%) may be prescribed for labial adhesions. [7] Topical imidazoles have been found to be effective in pregnant women with VVC, but a longer treatment regimen may be required. [10-12] Surgical treatment may be recommended to correct abnormalities such as vaginal agenesis or obstruction.

Differential Diagnosis of Congenital and Acquired Vulvar Abnormalities in Pregnancy

Pregnant women with congenital or acquired abnormalities of the vulva may present with various symptoms that can be challenging to diagnose. A differential diagnosis is essential to rule out other conditions that may mimic the symptoms of a vulvar abnormality.

Congenital Abnormalities

• Vaginal agenesis: This condition, also known as Mayer-von Rokitansky-Küster-Hauser syndrome (MRKH), is characterized by the absence or underdevelopment of the vagina. The differential diagnosis includes androgen insensitivity syndrome, which is described above [11].
• Transverse vaginal septum: This is a rare congenital abnormality where a septum forms across the vagina, causing obstruction [13].

Acquired Abnormalities

• Vulvar intraepithelial neoplasia (VIN): This is a precancerous condition that can cause vulvar lesions. The differential diagnosis includes benign vulvar melanosis and other conditions such as angiokeratoma of the vulva, lymphangioma circumscriptum of the vulva, and Fabry's Anderson disease [8].
• Vulvodynia: This is a chronic pain syndrome that affects the vulva. The differential diagnosis includes other causes of vulvar pain such as vestibulodynia and provoked vestibulodynia.

Delivery Considerations

In pregnant women with congenital or acquired abnormalities of the vulva, delivery may be complicated by:

• Obstructed labor: This can occur if there is a transverse vaginal septum or other obstruction [5].
• Prolonged labor: Women with vaginal agenesis or other congenital abnormalities may experience prolonged labor due to difficulty in dilation and effacement of the cervix.
• Malpresentation: The baby may not be in the correct position for delivery, which can increase the risk of complications.

References

[1] Congenital anomalies of the vulva and vagina include MRKH syndrome, vaginal agenesis, and transverse vaginal septum. [2] Congenital or acquired hernia should also be considered in the differential diagnosis. [3] Female genital tract anomalies may be associated with other medical conditions, either congenital or acquired. [4] The differential diagnosis includes benign vulvar melanosis and vulvar intraepithelial neoplasia.