Congenital Uterine Anomalies

 

  • Arrested Mullerian Duct Development.
    • Bilateral = Uterine aplasia.
    • Unilateral = Unicornuate uterus   (uterus unicornis unicollis).
    • Solitary uterine cavity and single fallopian tube

 

  • Total / Partial failure of Mullerian Duct Development.
    • Uterine didelphis (complete duplication).
      • 2 uteri, 2 cervices, 2 vaginas.
    • Bicornuate uterus - Bicollis (2 uterine horns, 2 cervices and 1 vagina)
    • Unicollis (2 uterine horns, 1 cervix and 1 vagina).

 

 

  • Non-resorption of sagittal uterine septum.
    • Total (Uterine septus).
    • Partial (Uterine subseptus)   /              * Arcuate.

 

  • Inadequate hormonal stimulation during fetal development.
    • Infantile uterus.
    • Uterine hypoplasia.
    • T shaped uterus (15% of women exposed to DES).

 

 

W – measurement of uterine width

F – Fundal distortion

C – Length of unaffected uterine cavity

Salim R et .al.

Reporoducibilty of three dimensional ultrasound diagnosis

Of congemital uterine anomalies.

Ultrasound Obstet Gynecol 2003;21:578-582

Uterine morphology

Contour of fundus

External contour

Normal

Straight or convex

Convex or Straight

Indentation < 10 mm

 

 

Arcuate

Concave fundal indentation

Central point of indentation at obtuse angle (>90 0)

Convex

Indentation < 10 mm

 

 

Subseptate

Septum which does not extend to cervix

Central point of septum at acute angle (<900)

Convex

Indentation < 10 mm

 

Septate

Uterine septum completely divides cavity from fundus to cervix

Convex

Indentation < 10 mm

 

 

 

 

 

 

Bicornuate

Two well formed cornu

Fundal indentation > 10mm dividing two cornu

 

Unicornuate

Single well formed uterine cavity with a single interstitial portion of Fallopian tube

Concave fundal contour

Fundal indentation > 10 mm dividing two cornu if rudimentary horn present

 

 

Didelphis

Two uteri

Two cervices

Two vaginas

 

 

 

T - shaped

 

 

 

 

 

 

 

Acquired

Link to Myomas (fibroids) versus Uterine contraction.

 

 

 

 

 

Previous Cesarean Section

 

 

 

Aschermans Syndrome.

 

 

 

 

Intrauterine contraceptive device (IUCD) and pregnancy.

 

 

 

 

 

 

Ovarian dermoid during pregnancy