CC BY-NC-ND 4.0 · AJP Rep 2024; 14(01): e26-e30
DOI: 10.1055/a-2208-0032
Case Report

Case Series of Reproductive Outcomes after Surgical Correction of Obstructed Hemivagina in OHVIRA

1   Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
2   Department of Pediatric and Adolescent Gynecology, Boston Children's Hospital, Boston, Massachusetts
Marc R. Laufer
2   Department of Pediatric and Adolescent Gynecology, Boston Children's Hospital, Boston, Massachusetts
› Institutsangaben
Funding None.


Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) is a rare congenital developmental syndrome manifested by uterine duplication, lower genital tract obstruction, and unilateral renal anomaly. Literature on reproductive outcomes in this patient population is limited. The aim of this study is to describe obstetric outcomes after surgical correction of obstructed hemivagina in a longitudinal cohort of patients with a diagnosis of OHVIRA. All cases of OHVIRA presenting to a single tertiary care children's hospital from 1990 to 2021 were retrospectively reviewed. Three cases demonstrating a variety of clinically important reproductive outcomes are described in detail including risks such as retained products, endometritis, preterm labor, and malpresentation. Understanding the reproductive outcomes associated with this diagnosis is important for practitioners seeking to counsel and care for patients with this diagnosis. This case series demonstrates a wide array of potential gynecologic and obstetric risks, though ultimately with successful term and near-term pregnancies.


● Data regarding any of the subjects in the study has not been previously published unless specified.

● Data will be made available to the editors of the journal for review or query upon request.


Reproductive outcomes after OHVIRA surgery are generally favorable but include a number of clinical risks that are important for patient–provider counseling.


Eingereicht: 02. März 2023

Angenommen: 19. Oktober 2023

Accepted Manuscript online:
09. November 2023

Artikel online veröffentlicht:
23. Januar 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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  • References

  • 1 Smith NA, Laufer MR. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil Steril 2007; 87 (04) 918-922
  • 2 Cappello S, Piccolo E, Cucinelli F, Casadei L, Piccione E, Salerno MG. Successful preterm pregnancy in a rare variation of Herlyn-Werner-Wunderlich syndrome: a case report. BMC Pregnancy Childbirth 2018; 18 (01) 498
  • 3 Santos XM, Dietrich JE. Obstructed hemivagina with ipsilateral renal anomaly. J Pediatr Adolesc Gynecol 2016; 29 (01) 7-10
  • 4 The American Fertility Society. Classification of endometriosis. Fertil Steril 1979; 32 (06) 633-634
  • 5 Haddad B, Barranger E, Paniel BJ. Blind hemivagina: long-term follow-up and reproductive performance in 42 cases. Hum Reprod 1999; 14 (08) 1962-1964
  • 6 Heinonen PK. Pregnancies in women with uterine malformation, treated obstruction of hemivagina and ipsilateral renal agenesis. Arch Gynecol Obstet 2013; 287 (05) 975-978
  • 7 Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, Raine-Fenning NJ. Reproductive outcomes in women with congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol 2011; 38 (04) 371-382
  • 8 Rikken JFW, Kowalik CR, Emanuel MH. et al. Septum resection versus expectant management in women with a septate uterus: an international multicentre open-label randomized controlled trial. Hum Reprod 2021; 36 (05) 1260-1267
  • 9 Silveira SA, Laufer MR. Persistence of endometriosis after correction of an obstructed reproductive tract anomaly. J Pediatr Adolesc Gynecol 2013; 26 (04) e93-e94
  • 10 Meuleman C, Vandenabeele B, Fieuws S, Spiessens C, Timmerman D, D'Hooghe T. High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners. Fertil Steril 2009; 92 (01) 68-74
  • 11 Ravasia DJ, Brain PH, Pollard JK. Incidence of uterine rupture among women with Müllerian duct anomalies who attempt vaginal birth after cesarean delivery. Am J Obstet Gynecol 1999; 181 (04) 877-881
  • 12 Gujral H, Bennett JA, Wright KN. Unilateral human papillomavirus infection and cervical dysplasia in a patient with two cervices. Obstet Gynecol 2016; 128 (03) 571-573
  • 13 Kaba M, Gungor T, Baser E, Ozdal B, Sirvan L. Cervical cancer in a patient with uterus didelphys and obstructive hemivagina, ipsilateral renal anomaly (OHVIRA) syndrome. Arch Gynecol Obstet 2013; 288 (01) 229-230