3. I thought……
I am a girl……
but the thought
remained as a thought
in my life…………………
4. The period when she realized that she is
different from all other girls…………
She did not have something which others
had………….
The day when she knew that she had…………
14. Signs & Symptoms……
Primary amenorrhea
Complete or partial absence of cervix, uterus and
vagina
Painful coitus
Hormonally normal
Enters puberty with development of secondary
sexual characteristics-adrenarche , thelarche
Chromosomal constellation-46XX
Ovaries intact…………ovulation
occurs………………….
15. But she cannot be………
A MOTHER
she cannot carry……….
A life in her womb
A life perhaps incomplete………
16. Forms of MRKH…..
Only absence of vagina and uterus
Absence of uterus and vagina +
40% kidney abnormalities
10% hearing problems
10-12% skeletal abnormalities
17. Solution?
No treatment to let the woman herself
become pregnant
Treatment available to make the intercourse
comfortable
18. Surgical Management
Frank technique or perineal dilation
apply progressive pressure to the
perineum using a bicycle-seat stool to hold a
dilator in place .
…………compliance may be poor………..
19. McIndoe technique
Split thickness skin graft -skin from thigh or
buttocks is used……..
PROCEDURE
Pocket created between rectum and urethra
↓
Place a cylindrical stent covered with skin graft
↓
Fix graft in place by attaching cut edges of skin
incission
20. ↓
Labia majora sutured loosely together
↓
1 week later remove stent
↓
irrigate vagina and cauterize areas of
granulation with silver nitrate sticks
21. Keep dilator in neovagina every day and night
for 3 months;
followed by
every night for next three months
………….scarring at donor site………
………….neovaginal stenosis…………
………….long term dilation……………
27. Means……
Surrogacy is an arrangement in which a woman
carries and delivers a child for another person
or couple……..
28. Surrogacy varies…….
Traditional surrogacy: woman may be child’s
genetic mother
Gestational surrogacy: carry pregnancy to
delivery after having an embryo, with no
genetic relationship, transferred to her uterus
Commercial surrogacy
Altruistic surrogacy
30. Characteristics of a
surrogate mother
Relative or close friend
Between 21 and 38 yrs of age
Given birth to one or more child previously with
no complications
No history of STDs
Good health………
31. Average weight for her height
A non-smoker who lives in a smoke free room
No illegal drug use
32. Arguements
Cost of surrogacy
Custody
Desperate needs home
Long process
Feel of Guilt