Gynecology and Pediatric Medicine (original) (raw)

2020, An Update on the Diagnosis, Classification and Management of Congenital Cervical Abnormal ities: A Systematic Review

After having reviewed in detail the management of congenital malformations overall where major work had been conducted by Ludwin A, here we chose to conduct a systematic review on classification and management of congenital cervical malformations with or without the presence or absence of vagina .We searched the pubmed engine, google scholar ,web of science ,Cochrane library, embase from 1970’s to 2020 till date in October, utilizing the MeSH terms cervical agenesis ;cervical dysgenesis, cervical obstruction; cervical remnants; vagina present ;vagina absent cervical fibrous cord; various surgical techniques used for constructing a neo cervix or neovagina with utilization of amnion ,dental mould as reported by us earlier for vaginoplasty in a case of Rokitansy Kuster Hauser Syndrome (RKHS) in 1980’s, other agents like small intestinal graft; split thickness graft partial or total skin. We found a total of 490 cases out of which we selected a total of 46 cases for this review. No meta-analysis was done. We observed just like maximum work with regards to construction of Roberts uterus and other congenital malformations work had been done, here in case of cervical malformations maximum reconstructive work had been conducted by the group of Gribizis GH who had also done considerable work in general malformations as well. Here we describe in detail the aims of conservative surgery instead of previous blanket hysterectomy plan with fear of endometriomas, hydrometrocolpos, -peritoneal adhesions. What are the aims of reconstructive surgery, like relieving blockade, obtaining sexual function along with menstruation and ensure fecundity is possible. All the techniques are discussed in detail in this review. Although success has been obtained in ensuring patency, attaining menstruation, pregnancy still lot of work needs to be done for standardization of techniques as most work comes from case reports or case series.