Unicornuate uterus

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Unicornuate uterus

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  • Failure of one müllerian duct to elongate while the other develops normally
  • Accounts for approximately 20% of müllerian duct anomalies.
  • The embryologic predominance of the unicornuate uterus to be on the right has not been explained.
  • Spontaneous abortion rates are reported to range from 41% to 62%.
  • Reported premature birth rates range from 10% to 20%
  • Fetal survival rates, from 38% to 57% (pooled data, 40%).
  • Renal abnormalities are more commonly associated with unicornuate uterus than with other müllerian duct anomalies
    • Reported in 40% of these patients.
    • Anomaly is always ipsilateral to the rudimentary horn.
    • Renal agenesis is the most commonly reported abnormality, occurring in 67% of cases.

Diagnosis

HSG

  • Endometrial cavity assumes a fusiform shape, tapering at the apex and draining into a solitary fallopian tube.
  • Uterus is generally shifted off of midline.

MRI

  • Unicornuate uterus appears curved and elongated, with the external uterine contour assuming a banana shape.
  • Uterine volume is reduced, and the configuration of the uterus is asymmetric.
  • Normal myometrial zonal anatomy is maintained.

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Patient #1

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Goldminer: Unicornuate uterus

References for Unicornuate uterus

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