Neonatal & Pediatric Pelvis GYN
Describe the appearance of a newborn uterus.
-prominent -thickened with brightly echogenic endometrial lining
By what gestational week are external sex organs fully developed?
12th
Until what gestation week do both sexes appear similar?
9th
Discuss the various types of mullerian anomalies.
Class 1: vaginal atresia -development of hydrocolpos, hydrometrocolpos, or hematometrocolpos Class 2: unicornuate uterus -related to infertility and pregnancy loss -cigar shaped uterus deviated to one side Class 3: uterus didelphys -complete duplication of uterus, cervix, and vagina -not usually associated with infertility problems Class 4: bicornuate uterus -duplication of uterus with common cervix -bilobed uterine cavity has wide-spaced cavities -low incidence of fertility complications Class 5: septate uterus -two uterine cavities are seen closely spaced with one fundus and sometimes two cervical canals or vaginal septum Class 6: related to DES exposure in utero -normal size uterus -T shaped cavity
diethylstilbestrol; drug that can cause a fetus to have a T-shaped uterine cavity
DES
Discuss the fundus-cervix ratio of newborn, prepubertal, and pubertal females.
Newborn -pear shaped uterus approx 3.5 cm in length -ratio of 1:2 Prepubertal -length will measure 2.5-3 cm -ratio of 1:1 Pubertal -length increases to 5-7 cm -ratio of 3:1
unclear genitalia
ambiguous genitalia
What is the most common pediatric germ cell tumor?
benign mature teratoma or dermoid cyst
duplication of uterus with a common cervix
bicornuate uterus
Where does the uterus get its arterial blood supply?
bilateral uterine arteries
List one clinical differential diagnosis of an ovarian teratoma.
bowel gas
What is the most common cause of female pseudohermaphroditism?
congenital virilizing adrenal hyperplasia
complete duplication of uterus, cervix, and vagina
didelphys uterus
sex organs in both male and female
gonads
collection of blood within the vagina and uterus
hematometrocolpos
condition in which both ovarian and testicular tissues are present
hermaphroditism
fluid-filled vagina
hydrocolpos
collection of fluid within the vagina and uterus
hydrometrocolpos
same sex
isosexual
What is the most accurate method for determining ovarian size?
measure the volume volume = length x height x width x 0.523
What type of anomalies has a high association with congenial anomalies of the uterus?
mullerian anomalies
also called paramesonephric ducts
mullerian ducts
an incompletely developed or immature ovum
oocyte
later forms oocytes
oogonium
form most of the female genital tract; also called mullerian ducts
paramesonephric ducts
early development of genitalia; mature on the inside
precocious puberty
appear as hermaphrodites but only have ovarian or testicular tissue
pseudohermaphroditism
Which uterine anomaly has the highest incidence of fertility problems?
septate uterus
two uterine cavities seen closely spaced; one fundus and sometimes two cervical canals or vaginal septum
septate uterus
A "cigar" shaped uterus refers to what mullerian anomaly?
unicornuate uterus
long and slender (cigar) shaped uterus deviated to one side
unicornuate uterus
tight vaginal canal; missing a portion
vaginal atresia