Clinical Image | DOI: https://doi.org/10.31579/2642-9756/117
1 Gynecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.
2 Gynecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.
*Corresponding Author: Aziz Slaoui, Gynecology-Obstetrics and Endoscopy Department, Mohammed V of Rabat Morocco
Citation: Aziz Slaoui, Nisrine Benaouicha, Mariam Mahtate, Brahim Rhrab, Najia Zeraidi. et all (2022). Potassium Permanganate Necrosis of the Vagina. J. Women Health Care and Issues. 5(3); DOI:10.31579/2642-9756/117
Copyright: © 2022 Aziz Slaoui, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 30 March 2022 | Accepted: 25 April 2022 | Published: 02 May 2022
Keywords: .
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A 19-year-old woman was referred to our emergency department for massive vaginal hemorrhage following an attempted clandestine abortion by intravaginal instillation of potassium permanganate crystals. Primigravida, she was 7 weeks pregnant and had no particular pathological history. Upon admission, she was in hemorrhagic shock with blood pressure at 7/3 mmHg and tachycardia at 152 bpm. Pelvic examination revealed active bleeding from the right vaginal wall. The cervix and vulva were normal. Mechanical hemostasis using a sterile gauze pad mounted on a long forceps was directly applied at the same time as the resuscitative management. After 3 minutes of compression, hemostasis was achieved and vaginal necrotic lesions appeared (Panels A and B).
The patient received an initial filling of 1 liter of lactated ringer's solution followed by transfusion of 3 units of red blood cells. Her hemoglobin was initially 7.2 g/dL and increased to 10.3 g/dL the next day. Pelvic ultrasound revealed an evolving monofetal pregnancy with a CCL of 12 mm corresponding to 7 weeks of amenorrhea and 4 days. On follow-up 2 weeks later, the embryo was still present with regular cardiac activity and her vaginal lesions were ulcerated and healing.
According to the World Health Organization, the rate of clandestine abortions in low- and middle-income countries mainly in Africa and Latin America, is estimated at 3% [1]. In these countries, where abortions are only legal if the pregnancy threatens the health or life of the mother, patients do not seek medical attention for complications for fear of legal action [2].
Potassium permanganate crystals were used in the mid-1950s to induce clandestine abortions [3]. In addition to the lethal hemorrhagic risk, cases of intestinal occlusion and pelviperitonitis have been described in the literature [3].
Practitioners should be aware of these types of potentially life-threatening complications in order to better manage patients [1]. But ultimately, it is prevention through sexuality education with a more efficient contraceptive offer that will best reduce unsafe abortions.
DECLARATIONS
Conflicts of interest
The authors declare that they have no competing interests.
Sources of funding
There are no funding sources to be declared.
Ethical approval
Ethics approval has been obtained to proceed with the current study.
Consent
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Guarantor of Submission
The corresponding author is the guarantor of submission.
Acknowledgements
None.
Availability of data and materials
Supporting material is available if further analysis is needed.
Provenance and peer review
Not commissioned, externally peer-reviewed.
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