title: Unusual case of OHVIRA syndrome with a single uterus, unrecognized before labor and followed by an intrapartal rupture of obstructed hemivagina.
abstract: OBJECTIVE
  The acronym for obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) was created to describe patients with an obstructed hemivagina and ipsilateral renal anomaly and enables inclusion of other uterine anomalies except uterus didelphys. The main goal of this article is to present a rare case of OHVIRA syndrome with intrapartal rupture of obstructed hemivagina.
  
  
  METHODS
  We present an unusual case of OHVIRA syndrome with single uterus, uterine septum (previously resected by hysteroscopy) and renal agenesis, unrecognized before labor and followed by an intrapartal rupture of obstructed hemivagina.
  
  
  CONCLUSIONS
  Various symptoms, included in OHVIRA acronym, are a result of different morphologic variants included in this syndrome. Most likely, in our case, the absence of communication between the cervical canal/patent vagina and the obstructed hemivagina prevented formation of mucocolpos or hematocolpos. This rare clinical variant made our MRI diagnosis of obstructed hemivagina, as well of the entire OHVIRA syndrome, ineffective. We did not find OHVIRA cases in the literature with a single septate uterus and single cervix, associated with obstructed hemivagina diagnosed during and after labor and presented with intrapartal rupture of hemivagina. Because of lack of guidelines, the final decision about management of the labor in such rare cases of OHVIRA syndrome is difficult.
authors.affiliation: Department of Gynecology and Obstetrics, "Sveti Duh" University Hospital, University of Zagreb, School of Medicine, Sveti Duh 64, 10000, Zagreb, Croatia, kresimirzivkovic@yahoo.com.
authors.forename: Krešimir
authors.initials: K
authors.lastname: Zivković
authors.forename: Matija
authors.initials: M
authors.lastname: Prka
authors.forename: Nikica
authors.initials: N
authors.lastname: Zivković
authors.forename: Ana
authors.initials: A
authors.lastname: Bucko
authors.forename: Dubravko
authors.initials: D
authors.lastname: Habek
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis*; D000328:Adult; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging; D017523:Croatia; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000151:congenital / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011256:Pregnancy Outcome; D013577:Syndrome; D016896:Treatment Outcome; D014463:Ultrasonography; D014564:Urogenital Abnormalities / Q000000981:diagnostic imaging; D014599:Uterus / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014621:Vagina / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery