Self medication with vaginal misoprostol in a term pregnancy: case report

The case of a woman with one previous Caesarean section, and severe pre-eclampsia at term, who self administered misoprostol by the vaginal route - without its being prescribed - in an attempt to avoid repeat caesarean section, is described. She eventually had vaginal delivery of a live female infant with cardiopulmonary depression; the delivery was not complicated by symptomatic uterine rupture. The potential for abuse of misoprostol, and the need to control distribution of the drug are discussed. Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 83-8

Primary vaginismus: treatment with botulinum toxin

Background: Vaginismus is a rare condition. It may result in unconsummated marriages with subsequent marital disharmony. The most severe forms of these spasms of the vaginal muscles are often refractory to a variety of conventional treatment.Case Report: The index case was a 35-year old nulligravid, civil servant who presented to the gynaecological outpatient clinic with a complaint of inability to have coitus since she married 5years prior to presentation. She had several counselling sessions by both gynaecologists and psychiatrists, and had used several forms of treatment with improvement in her condition. She, subsequently, had successful treatment with intra-vaginal botulinum toxin injection.Conclusion: In cases of severe vaginismus, botulinum toxin injection can be considered as a first line option of treatment.Keywords: BotoxR, fear, penetration, spasm, vagina