Clitoromegaly in type 2 neurofibromatosis: a case report and review of the literature.

OBJECTIVE: Genitourinary neurofibromatosis (NF) is a rare disorder and clitoral involvement has been reported infrequently. In the English literature there are only 26 reported cases with clitoral involvement in NF. CASE: A 28-year-old female with clitoral enlargement, previously diagnosed with NF 2, was successfully treated by removal of the clitoral mass that increased in size during the previous two years. Clitoroplasty was performed while preserving the glans of clitoris. Histopathologic examination revealed plexiform neurofibroma. CONCLUSION: To the best of our knowledge the patient is the 27th reported clitoromegaly case with NF, but the first case reported with NF 2 or central NF in the English literature.

Ruptured uterus.

Uterine rupture, an important cause of maternal and fetal mortality, is still occasionally seen in our region. In this study we reviewed 41 cases of uterine rupture encountered between the years 1983 and 1988, in a total of 3962 hospital deliveries with a frequency of 1 in 96.6 deliveries. Sixteen cases (39.0%) were over 35 years old. Twenty-five patients (60.9%) were grand multiparous (more than five pregnancies). There were no uterine ruptures in primigravid women. Ruptures were mostly (75.6%) due to cephalopelvic disproportion. Subtotal hysterectomy was the first choice of management for 35 cases. The maternal mortality rate was 7.3% while fetal mortality was 82.9%. Midwife education, regular antenatal care and hospital deliveries are important factors in prevention of this obstetric hazard.