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Objective: This study aimed to describe the clinical features, associated extragenital anomalies, and management of Mayer- Rokitansky-K?ster-Hauser (MRKH) syndrome in young women Methods: For this case series, we analyzed the medical records of 20 patients with MRKH syndrome diagnosed and treated at AIIMS Bhopal, a tertiary referral center in central India over one year Results: The study included 20 patients with MRKH syndrome. Thirteen patients did not have extragenital malformations and were diagnosed with MRKH type I (typical form), whereas rest seven were categorized as MRKH type II (atypical form). Extragenital anomlaies included skeletal malformations, renal and cardiac malformation. Clinical vaginal examination revealed complete atresia in 12 and vaginal hypoplasia in 8 patients. Most of the patients did not receive treatment because they had not engaged in sexual intercourse. Surgical details of three patients who underwent surgical reconstruction of the vagina is demonstrated in figures. Conclusion: This study confirmed the complexity and heterogeneity of the phenotypic manifestations of MRKH, including the degree of vaginal atresia and types and rates of associated malformations.