Uterine malformation

Revision as of 17:15, 20 August 2012 by WikiBot (talk | contribs) (Robot: Automated text replacement (-{{SIB}} +, -{{EH}} +, -{{EJ}} +, -{{Editor Help}} +, -{{Editor Join}} +))
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search
Uterine malformation
A human bicornuate uterus
ICD-10 Q51
ICD-9 752.2-752.3

WikiDoc Resources for Uterine malformation

Articles

Most recent articles on Uterine malformation

Most cited articles on Uterine malformation

Review articles on Uterine malformation

Articles on Uterine malformation in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Uterine malformation

Images of Uterine malformation

Photos of Uterine malformation

Podcasts & MP3s on Uterine malformation

Videos on Uterine malformation

Evidence Based Medicine

Cochrane Collaboration on Uterine malformation

Bandolier on Uterine malformation

TRIP on Uterine malformation

Clinical Trials

Ongoing Trials on Uterine malformation at Clinical Trials.gov

Trial results on Uterine malformation

Clinical Trials on Uterine malformation at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Uterine malformation

NICE Guidance on Uterine malformation

NHS PRODIGY Guidance

FDA on Uterine malformation

CDC on Uterine malformation

Books

Books on Uterine malformation

News

Uterine malformation in the news

Be alerted to news on Uterine malformation

News trends on Uterine malformation

Commentary

Blogs on Uterine malformation

Definitions

Definitions of Uterine malformation

Patient Resources / Community

Patient resources on Uterine malformation

Discussion groups on Uterine malformation

Patient Handouts on Uterine malformation

Directions to Hospitals Treating Uterine malformation

Risk calculators and risk factors for Uterine malformation

Healthcare Provider Resources

Symptoms of Uterine malformation

Causes & Risk Factors for Uterine malformation

Diagnostic studies for Uterine malformation

Treatment of Uterine malformation

Continuing Medical Education (CME)

CME Programs on Uterine malformation

International

Uterine malformation en Espanol

Uterine malformation en Francais

Business

Uterine malformation in the Marketplace

Patents on Uterine malformation

Experimental / Informatics

List of terms related to Uterine malformation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


A uterine malformation is the result of an abnormal development of the Mullerian duct(s) during embryogenesis. Symptoms range from amenorrhea, infertility and pain, to normal functioning depending on the nature of the defect. Uterine malformations affect about 1% of the female population.

Types

The American Fertility Society (now American Society of Reproductive Medicine) Classification distinguishes:

  • Class I: Mullerian agenesis (absent uterus).
    • Uterus is not present, vagina only rudimentary or absent. The condition is also called Mayer-Rokitansky-Kuster-Hauser syndrome. The patient with MRKH syndrome will have primary amenorrhea.
  • Class II: Unicornuate uterus (a one-sided uterus).
    • Only one side of the Mullerian duct forms. The uterus has a typical "banana shape" on imaging systems.
  • Class III: Uterus didelphys, also uterus didelphis (double uterus).
    • Both Mullerian ducts develop but fail to fuse, thus the patient has a "double uterus". This may be a condition with a double cervix and a vaginal partition (v.i.), or the lower Mulllerian system fused into its unpaired condition. See Triplet-birth with Uterus didelphys for a case of a woman having spontaneous birth in both wombs with twins.
  • Class IV: Bicornuate uterus (uterus with two horns).
    • Only the upper part of that part of the Mullerian system that forms the uterus fails to fuse, thus the caudal part of the uterus is normal, the cranial part is bifurcated. The uterus is "heart-shaped".
  • Class V: Septated uterus (uterine septum or partition).
    • The two Mullerian ducts have fused, but the partition between them is still present, splitting the system into two parts. With a complete septum the vagina, cervix and the uterus can be partitioned. Usually the septum affects only the cranial part of the uterus. A uterine septum is the most common uterine malformation and a cause for miscarriages. It is diagnosed by medical image techniques, ie a hysterosalpingogram, ultrasound, or an MRI, and can be corrected by hysteroscopic surgery.
  • Class VI: DES uterus.

An additional variation is the arcuate uterus where there is a concave dimple in the uterine fundus within the cavity.

A rudimentary uterus is an uterine remnant not connected to cervix and vagina and may be found on the other side of an unicornuate uterus.

Patients with uterine abnormalities may have associated renal abnormalities including unilateral renal agenesis.[1]

"Double vagina"

Uterine Didelphys is a rare type of deformity (1 in 1000 women) in the female reproductive organs in which some organs may be either split or duplicated. Typically, some of these "extra" organs are non-functional or semi-functional appendages, although on occasion they will be completely functional in all normal respects, and often independently. As the vagina is largely derived from the Mullerian ducts, lack of fusion of the two ducts can lead to the formation of a vaginal septum, or "double vagina", a condition sometimes called with a uterus didelphys or a uterine septum.[2][3][4]

Diagnosis

Besides a physical examination, the physician will need imaging techniques to determine the character of the malformation: gynecologic ultrasonography, pelvic MRI, or hysterosalpingography. In addition, laparoscopy and/or hysteroscopy may be indicated. In some patients the vaginal development may be affected.

Treatment

Surgical intervention depends on the extent of the individual problem. With a didelphic uterus surgery is not usually recommended.

References

  1. Li S, Qayyum A, Coakley FV, Hricak H. Association of renal agenesis and mullerian duct anomalies. J Comput Assist Tomogr. 2000 Nov-Dec;24(6):829-34. PMID 11105695
  2. Heinonen PK.Complete septate uterus with longitudinal vaginal septum.Fertil Steril. 2006 Mar;85(3):700-5. PMID 16500341
  3. Perez-Brayfield MR,Clarke HS,Pattara JG. Complete bladder, urethral, and vaginal duplication in a 50-year-old woman. Urology. 2002 Sep;60(3):514. PMID 12350504
  4. British Woman With 2 Wombs Has Triplets. Associated Press, 22 Dec. 2006.

See also

External links


Template:WikiDoc Sources