Transverse Septa of the Vagina

Anomalies of the vagina are of interest not only to the obstetrician and gynecologist, but also to the general practitioner. When so extensive as to interfere with menstruation, sexual activities, oi with accouchement the effect of such anomalies upon the physical and mental health of the individual may be of considerable significance. Among the many possible abnormalities of the vagina, transverse septa play a small but important part. Transverse ridges across the vaginal canal occur frequently, but transverse septa sufficiently extensive to give rise to dystocia are rarely encountered. In a discussion of dystocia due to abnormalities of the generative tract, Williams"5 states that occasionally the upper portion of the vagina is separated from the lower by a diaphragmatic structure perforated by a small central opening. This diaphragm, if not ruptured by the pressure of the presenting part, must be incised in order to permit the descent of the head. Micholitsch' discovered, in a patient to whom he was called late in labor, such a septum as the cause of delay in the second stage. Subsequently rupture took place and labor proceeded uneventfully. During the puerperium it was noted that the torn ends of the septum formed transverse ridges in the vaginal walls. Monro10 found a fully formed transverse septum of the vagina in a twenty-two-year-old female who was six months pregnant. The septum ruptured during delivery but evidence of the structure persisted as transverse vaginal ridges. Goinard's7 patient presented the signs of acute shock following a three months' period of amenorrhea. Upon vaginal examination a septum was found above which were the products of an incomplete abortion and a large accumulation of blood. Stone14 reports five instances of this anomaly. Three occurred in young women who had never suffered injury and were pregnant for the first time. In one the septum was located two inches above the posterior fourchette and was perforated