Vaginal wall chang
Hanaa Farouk1, AminahAbd El Fatah1,Khadra Ibrahim1 and WafaaHelmy2.
1Obstetrics &Gynacology and 2Pathology Departments, Al-Azhar University, Egypt.
Abstract: Introduction: The vagina is central to pelvic organ support such that a normally supported vagina will resist downward descent of the uterus, urethra, bladder, and rectum. If the structural and mechanical integrity of the vagina and/or the structures that support it are compromised, pelvic organ prolapse may occur. Maternal birth injury subsequent to vaginal delivery is considered the greatest risk factor for the development of prolapse. Objective: to determine the effect of stretching and vaginal distention involved in vaginal delivery on the structure of muscles and connective tissue of the vaginal wall. Study Design: pilot retrospective case-control study. Aim of the work: reduce the risk of birth injuries and preserve the vaginal tissues from being redundant and unhealthy. place and duration: Department of Obstetrics & Gynacology, faculty of medicine-Azhar University from march to july2012 . Patient & Method: 40 women aged 20 to 35 years were enrolled in this study subdivided into two groups ,study&control each consists of 20 women. The study group includes women who gave birth through NVD, and control group includes women who gave birth through C.S. All women were subjected to full history taking with special regards to (age, parity and mood of delivery) and full clinical examination (general, abdominal and local examination). A full-thickness vaginal specimen was obtained from all women and all specimens were fixed in formalin (10%) for 24h. then Cross sections of the formalin-fixed, paraffin-embedded tissues will be obtained for histopathology study using heamatoxylin and eosin. Special cytochemistry Trichrome staining will be used for evaluation of fibrocollagenous stroma and vaginal wall smooth muscle changes. Results: . Redundant vaginal wall was noticed in 8 out of 20 NVD cases (40.0 %). vaginal redundancy was noticed more frequently with increased parity. We found that vaginal redundancy was 40% in women with vaginal delivery as compared to 0.0% in women with cesarean section (C.S) (p = 0.002). All women with redundant vagina have altered vaginal tissue histomorphology in the form of: Minimal total vaginal collagen, loose fibrocollagenous stroma, severely affected muscle integrity (muscle bundles are smaller, splitted, fragmented and disorganized compared with control group). Conclusion: Vaginal parity was associated with alternation of the vaginal tissue histomorphology that affect the vaginal condition to be redundant.
[Hanaa Farouk, Aminah Abd El Fatah, Khadra Ibrahim and Wafaa .Helmy. Vaginal wall changes in muscles and connective tissues after vaginal birth. Life Sci J 2013;10(1):2816-2823] (ISSN:1097-8135).http://www.lifesciencesite.com.
Keyword : histopathology of vaginal wall after vaginal birth, pelvic organ prolapse.