Mullerian duct anomalies

Septate uterus

-*most common* -can be complete (septum extends to cervix) or partial -associated with spontaneous pregnancy loss (due to compromised implantation in avascular area)

Complete agenesis of Mullerian structures

-called Rokitansky Kunster Hauser syndrome -presentation: amenorrhea -will have no upper vagina, cervix, uterus, or tubes -renal and skeletal anomalies -treatment: create a neovagina

DES/ T-shaped uterus

-caused by diethlstilbersterol (teratogen used in the 50s to prevent miscarriage) -at risk for pregnancy loss -also at risk for clear cell carcinoma of the vagina

General

-embryologic -may be isolated -may be part of a syndrome or assoc. with other birth defects -may or may not cause reproductive problems -prevalence: 1-5% of general population 13-25% of women with miscarriages

Imperforate hymen

-failure of reabsorption of uterovaginal septum -presentation: amenorrhea, cyclic pain, abdominal mass -treatment: hymenotomy -*lecture*: obstructions can cause secondary endometriosis

Mullerian ducts

-fuse to form tubes, uterus, cervix, and upper 1/3 vagina -lower vagina formed from invagination of perineal body -timeline: fusion of ducts at 6-11 weeks uterovaginal septum resorbs at 9-12 weeks (cranial to caudal)

Bicornuate uterus

-has *cleft* in external contour of uterine funds (external cleft separates from septet uterus) -partial or complete -often asymptomatic -may have longitudinal vaginal septum

Unicornate uterus

-normal development of one horn -two ovaries -*renal anomalies* accompany 40% of cases on ipsilateral side -obstetrics: can have normal outcome, preterm labor, or malpresentation (breech)

Uterus Didelphys

-results from complete failure of duct fusion -two separate uteri, tubes, endometrial cavities and cervices -duplicated upper vagina (septum) -renal agenesis on one side -obstetrics: normal outcomes or preterm labor