Mullerian duct anomalies diagnosed by saline contrast. Like other organs in the body, a womans reproductive organs take shape when she is still a fetus inside her mothers uterus. Congenital uterine anomalies and their impact on fertility. Type ii, which is accompanied by mullerian duct remnants 30%. Fusion of the mullerian ducts normally occurs between the 6th and 11th weeks of gestation to form the uterus, fallopian tubes, cervix, and proximal twothirds of the vagina. Mullerian and wolffian ducts are so closely related embryologically that mullerian anomalies are commonly associated with anomalies of kidney and ureter. These congenital anomalies usually result from one of the following categories of abnormalities of the mullerian ducts. However, in certain cases, the uterus and fallopian tubes may not form normally. Mullerian duct anomalies are rare and can present with abnormalities in upper vagina, cervix, uterus, and. Ppt mullerian anomalies powerpoint presentation free to download id. Factors that precipitate include genetics, and maternal exposure to teratogens. The herlynwernerwunderlich hww syndrome is a rare variant of mullerian duct anomalies characterised by the combination of uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis. The obstetric consequences of uterovaginal anomalies fertility and. The paramesonephric ducts play a critical role in the female reproductive tract and differentiate to form the uterine tubes, uterus, superior vagina as well as the uterine cervix.
The present study aimed to assess the value of threedimensional transvaginal sonography 3dtvs in comparison with pelvic mri to diagnose uterine anomalies. Mri findings in 48 patients with mullerian duct anomalies. Persistent mullerian duct syndrome pmds is a disorder of sexual development that affects males. Longitudinal vaginal septum gardner duct cysts mullerian anomalies segmental mullerian hypoplasiaagenesis unicornuate uterus uterus didelphis. As detailed in part 1 of this installment on uterine anomalies, a uterus that has developed abnormally can appear to be normal on 2d sonography and on unenhanced sonohysterography figure. Ppt mullerian anomalies powerpoint presentation free. Type i, which is associated with an inguinal hernia and accounts for 4050% of the cases. However, they also have a uterus and fallopian tubes female reproductive organs. The objective of our study was to assess agreement between mri and clinical diagnosis of mullerian duct anomalies and identify causes of. Embryology two paired mullerian ducts ultimately develop into. The role of imaging is to detect and classify these mda so that appropriate treatment. These malformations can involve a single organ or can be a combination. Techniques for surgically correcting these anomalies are discussed elsewhere in these volumes and in other texts. Rowling md, in radiology secrets plus third edition, 2011.
Abnormalities of the female reproductive tract mullerian defects download a pdf of this fact sheet here. Embryological development, classification, and mri assessment. Interruption of normal development of the mullerian ducts can result in formation of mullerian duct anomalies mdas. Comparison of the eshreesge and asrm classifications of. Mullerian duct anomalies are classified according to the american fertility society system here. Pdf mullerian duct anomalies omar shaaban academia. Failure of this results in uterine agenesishypoplasia or a unicornuate uterus. Hypomelia mullerian duct anomalies genetic and rare.
This may be as a result of complete agenesis, defective vertical or lateral fusion, or resorption failure. Mri provides an excellent, noninvasive method of differentiating between the different types of anomaly and is an important part of the comprehensive clinical assessment to determine management. The clinician must manage these problems and be prepared to counsel affected individuals concerning the recurrence risks to other family members. Three main principles governs the practical approach to mullerian anomalies. Mullerian duct anomalies kel kongenital wanita uterus. The classification of nonobstructive uterine anomalies disor. Mullerian ducts, congenital uterine anomalies, classification system, septate uterus, uterine septum. Some uterine anomalies can be accurately diagnosed with us, such as absent. Pdf surgical management of mullerian duct anomalies. Abnormalities of the female reproductive tract mullerian. Uterine malformation an overview sciencedirect topics. Mullerian duct anomalies mdas are rare, affecting approximately 1% of all women and about 3% of women with poor reproductive outcomes. Mullerian duct anomalies mda are common female genital tract malformations. Mullerian duct anomalies are an uncommon but often treatable cause of infertility.
Males with pmds have normal male reproductive organs and normal male external genitalia. Mullerian ducts and resorption of the resulting septum to form a single uterovaginal canal. For language access assistance, contact the ncats public information officer. The estimated incidence of mullerian duct anomalies range between 2 to 10% based on the studied population. The adobe flash plugin is needed to view this content. In cases of septate vagina, dyspareunia was a presenting symptom, accounting for 8. View enhanced pdf access article on wiley online library html view download pdf for offline viewing.
Occasionally a uterine horn can become obstructed and cause hematocolpos, or hematometrocolpos. Gale academic onefile document mullerian duct anomalies. Congenital uterine anomalies are clinically important, especially in women who present infertility. Mullerian anomalies yes, almost all adverse pregnancy risks have been shown in some studies to be associated with any of the anomalies first trimester loss uterine septum even this is somewhat controversial, and surgical correction has been shown in smaller studies to improve results no place for surgery for fusion defects that. Mullerian duct anomalies kel kongenital wanita free download as powerpoint presentation. Though these anomalies are asymptomatic,they have major impact on female reproductive system and cause some major issues like abortion. Organogenesis is characterised by the formation of both mullerian ducts. Mullerian duct anomalies present with developmental malformations of the vagina, cervix, uterus or fallopian tubes. The educational objectives of this continuing medical education activity are for the reader to exercise, selfassess, and improve skills in diagnostic radiology with regard to the interpretation of hysterosalpingograms and magnetic resonance imaging mri of the female pelvis in the evaluation of recurrent reproductive failure caused by congenital uterine anomalies. Without the application of 3d coronal ultrasonography, accurate identification of the fundal contour, and ultimately the type and classification of the uterine anomaly, is not possible. Persistent mullerian duct syndrome genetic and rare. Magnetic resonance imaging of classified and unclassified mullerian. Mullerian anomalies are congenital defects of the female reproductive tract resulting from failure in the development of the mullerian ducts and their associated.
Sequence variant in the cdc42bpb gene is potentially. Wolffian duct an overview sciencedirect topics descent of mesonephric duct to the final position of the vas. Apart from malrotation and ptosis, no other consistent renal or urological abnormalities have been described. Anomalies that develop within the paramesonephric duct system continue to puzzle and fascinate obstetricians and gynecologists. These lead to the occurrence of different uterine anomalies. In the largest series reporting the incidence of renal anomalies in patients with mullerian duct anomalies mdas, renal agenesis has been found in around 30% of patients. Mullerian anomalies in the pediatric and adolescent population. Role of threedimensional transvaginal sonography compared.
Download a free qr code scanner by searching for qr scanner in your smartphones app store or app marketplace. If you have problems viewing pdf files, download the latest version of adobe reader. Many are asymptomatic and have been associated with normal and adverse reproductive outcomes. This is the classic appearance of uterine didelphys. Media in category mullerian duct anomalies the following 3 files are in this category, out of 3 total. Although many genes and mutations have been found to be associated with the pathogenesis of mda, in most cases, the genetic pathogenic factors of mda are still unknown. The afs classification of mullerian anomalies table 5 did not include one abnormality that i have recently encountered and i suggest that it should be considered for inclusion in the septate group of anomalies.