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11:24 am - How to get pregnant from a blowjob

http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3191066&dopt=Abstract



British Journal of Obstetrics and Gynecology. September 1988, Vol. 95,

pp. 933-934



Oral conception. Impregnation via the proximal gastrointestinal tract in

a patient with an aplastic distal vagina. Case report.



Douwe A. A. Verkuyl



Case report



The patient was a 15-year-old girl employed in a local bar. She was

admitted to hospital after a knife fight involving her, a former lover and

a new boyfriend. Who exactly stabbed whom was not quite clear but all

three participants in the small war were admitted with knife injuries.,

The girl had some minor lacerations of the left hand and a single

stab-wound in the upper abdomen. Under general anaesthesia, laparotomy

was performed through an upper midline abdominal incision to reveal two

holes in the stomach. These two woulds had resulted from the single

stab-wound through the abdominal wall. The two defects were repaired in

two layers. The stomach was noted empty at the time of surgery and no

gastric contents were seen in the abdomen. Nevertheless, the abdominal

cavity was lavaged with normal saline before closure. The condition of

the patient improved rapidly following routine postoperative care and she

was discharged home after 10 days. Precisely 278 days later the patient

was admitted again to the hospital with acute, intermittent abdominal

pain. Abdominal examination revealed a term pregnancy with a cephalic

fetal presentation. The uterus was contracting regularly and the fetal

heart was heard. Inspection of the vulva showed no vagina, only a shallow

skin dimple was present below the external urethral meatus and between the

labia minora.



An emergency lower segment caesarian section was performed under spinal

anaesthesia and a live male infant weighing 2800 g was born, with Apgar

scores of 7 and 9 at 1 and 5 minutes, respectively. On exploration,

through the nearly completely dilated cervix, it was found that the normal

uterus ended in a 2 cm deep vagina and that the vagina did not exist more

distally.







The uterus, adnexa and renal tract appeared normal. Routine closure of

the uterus and abdomen followed; a large tube drain was left in the

uterine cavity.



While closing the abdominal wall, curiosity could not be contained any

longer and the patient was interviewed with the help of a sympathetic

nursing sister. The whole story did not become completely clear during

that day but, with some subsequent inquiries, the whole saga emerged.







The patient was well aware of the fact that she had no vagina and she had

started oral experiments after disappointing attempts at conventional

intercourse.



Just before she was stabbed in the abdomen she had practiced fellatio with

her new boyfriend and was caught in the act by her former lover. The

fight with knives ensued. She had never had a period and there was no

trace of lochia after the caesarian section. She had been worried about

the increase in her abdominal size, but could not believe she was pregnant

although it had crossed her mind more often as her girth increased and as

people around her suggested that she was pregnant. She did recall several

episodes of lower abdominal pain during the previous year. The young

mother, her family, and the likely father adapted themselves rapidly to the

new situation and some cattle changed hands to prove there were no hard

feelings.



The postoperative course was uneventful and the drain was removed on the

6th day. She started complaining about lower abdominal pain 8 months

postpartum while she was still breastfeeding. An attempt was made to

construct a vagina by tunneling between the urethra and rectum. A

proximal vagina filled with old blood was found after 3-4 cm as described

by Jeffcoate (1975). The tunnel was now dilated with appropriate

instruments. It was found impossible to suture the skin of the introitus

to the wall of the proximal vagina as advocated by Jeffcoate and

criticized by others (Dewhurst 1981). A mould was constructed from a 20

cm^3 plastic syringe cylinder with the distal end removed. The mould was

fixed with nylon sutures to the labia and left in place for 2 weeks. The

patient was discharged with a few oversized cervical dilators and

instructed in their use. Follow-up was difficult, the patient was seen

only some moths later with a stenosed vagina and lower abdominal pain.

Another reconstruction was attempted though scar tissue with much the same

result.

Because she refused to have a hysterectomy and her cryptomenorrhea was

very painful, high doses of depot medroxyprogresterone were used to induce

amenorrhea. This was partly successful, but a hysterectomy become

necessary to afford her relief from crippling pain when were son was 2.5

years old. By that time the son looked very much like the legal father.



Comments



A plausible explanation for this pregnancy is that spermatozoa gained

access to the reproductive organs via the injured gastrointestinal tract.

It is known that spermatozoa do not survive long in an environment with a

low pH (Jeffcoate 1975), but it is also known that saliva has a high pH

and that a starved person does not produce acid under normal

circumstances (Bernard & Couman 1976).



It is likely that the patient became pregnant with her first or nearly

first ovulation otherwise one would expect that inspissated blood in the

uterus and salpinges would have made fertilization difficult. The fact

that the son resembled the father excludes an even more miraculous

conception.