Female Hermaphroditism and Term Pregnancy: About a Case at the National Hospital of Pikine and Review of Literature

Taliana Stéphie Gondjout, O. Gassama, Soukaina El Alaoui, H. Chami, A. Diouf, A. Diouf
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Abstract

This case report, it’s about a patient I met during prenatal consultation, she was in the 2nd semester of her pregnancy, exactly at 25 weeks. During the physical examination, we found, she had a hypoplasia of minor labia, an incomplete vaginal diaphragm with a vaginal cup, and a hypertrophy of clitoris. We decide to make some biological and instrumental examinations. After getting the result, we concluded she has a pseudo hermaphroditism associated with malformation of 1/3 of vagina. Reason why the way of the delivery choose was a C-section. Female pseudo hermaphroditism is the most frequent (FPH) sexual ambiguity. It is characterized by the extension of abnormality of the sexual differentiation during the fetal life in the female fetus by a maternal or fetal hyper-genesis. The authors propose through a clinical case with a patient 46XX DSD pregnant. The main cause of this pathology is congenital adrenal hyperplasia, which we lead to deficits of 21-hydoxylase, 11-beta-hydroxylase, 3-beta-hydroxysteroid dehydrogenase, but 95% of the congenital adrenal hyperplasia is the deficiency of 21-hydoxylase. The treatment of congenital adrenal hyperplasia depend of the cause, hormone replacement therapy like (dexamethasone, hydrocortisone), most often the treatment for life is needed. From this we propose to make review of literature focusing on it.
女性雌雄同体与足月妊娠:关于国立匹肯医院一例及文献复习
这个病例报告,是关于我在产前咨询时遇到的一个病人,她在怀孕的第二学期,正好是25周。在体检中,我们发现她有小阴唇发育不全,阴道膈不完整伴阴道杯状,阴蒂肥大。我们决定做一些生物和仪器检查。在得到结果后,我们得出结论,她是假雌雄同体,并伴有1/3的阴道畸形。分娩方式选择剖腹产的原因。雌性伪雌雄同体是最常见的性别歧义。它的特点是通过母体或胎儿的超发生,使女性胎儿在胎儿期性别分化异常的扩展。作者通过一个临床病例与患者46XX DSD怀孕提出。这种病理的主要原因是先天性肾上腺增生,导致21-羟化酶、11- β -羟化酶、3- β -羟基类固醇脱氢酶缺乏,但95%的先天性肾上腺增生是21-羟化酶缺乏。先天性肾上腺增生症的治疗视病因而定,激素替代疗法如(地塞米松、氢化可的松),多数情况下需要终身治疗。在此基础上,我们拟对相关文献进行综述。
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