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I was called at 2 a. m. to attend Mrs. N., aged 27, a primipara, well developed and well nourished, in labor. Her condition Was normal. Pains had been coming very strong every five minutes for two hours. I did not know her condition until after the examination, after which I found that she had an imperforate anus, the rectum opening into the vagina 2 inches from the vaginal orifice. At the opening of the rectum there was an elliptical sphincter, which, though light, was sufficient to give the patient control of her bowels.
She had a very firm perineal body or muscular band extending from the true perineal body posteriorly to the coccyx. The sacrum bulged somewhat forward. The vaginal orifice would admit only two fingers and that with considerable difficulty, causing much discomfort to the patient. The clitoris was somewhat enlarged and very firm. A condition of hypospadias
SMILEY O. MOTHER WITH IMPERFORATE ANUS DELIVERED OF NORMAL CHILD. JAMA. 1911;LVII(26):2047. doi:10.1001/jama.1911.04260120237003
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