Pregnancy with a microperforated hymen

In fetal life the hymen separates the evaginated caudal end of the fused fetal paramesonephric ducts from the evaginated urogenital sinus. It may persist as a result of infection during intrauterine life; or if the epithelial cells in its center do not degenerate to produce the membrane; or if, because of excessive cell proliferation and coalescence, the area behind it does not regress. Discussions of hymenal anomalies tend to emphasize the diagnosis and treatment of imperforation in infertility cases w1,2x. We describe the case of a 21year-old woman who was incidentally found to have a microperforate hymen in the 27th gestational week of her first pregnancy. The presenting complaint was abdominal pain. The clinician sensed the presence of a membrane on bimanual pelvic examination. Careful inspection revealed an intact, microperforate hymen that was easily stretched by the examiner’s fingers and then reverted to its original configuration. The woman reported normal, regular periods of 4 days’ duration every 30 days since the age of 14 years, and exclusive use of pads (not tampons). She had coitus for the first time on her wedding night,