Miss O., aged 28, was admitted to the Deaconess Hospital, March 19, 1923, having been in labor eighteen hours, with pains on admission at five minute intervals and resembling those of a well advanced second stage. On routine examination it was apparent that an abnormality existed, but the patient was so unruly that an anesthetic was necessary to determine the condition present.
The external genital organs had the appearance of virginity; the labia majora were normal, and the space between was covered with mucous membrane. The urethral orifice was markedly dilated, easily admitting the index finger to the interior of the bladder. No vaginal outlet could at that time be determined, and it was supposed that the vagina opened into the bladder.
By rectal examination the head could be felt well down in the pelvis and the cervix about two thirds dilated.
A cesarean section with hysterectomy was the only