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Unicornuate Uterus
A unicornuate uterus represents a uterine malformation where the uterus is formed from one only of the paired Müllerian ducts while the other Müllerian duct does not develop or only in a rudimentary fashion. The sometimes called ''hemi-uterus'' has a single horn linked to the ipsilateral fallopian tube that faces its ovary. Signs and symptoms Women with the condition may be asymptomatic and unaware of having a unicornuate uterus; normal pregnancy may occur. In a review of the literature Reichman et al. analyzed the data on pregnancy outcome of 290 women with a unicornuate uterus. 175 women had conceived for a total of 468 pregnancies. They found that about 50% of patients delivered a live baby. The rates for ectopic pregnancy was 2.7%, for miscarriage 34%, and for preterm delivery 20%, while the intrauterine demise rate was 10%. Thus patients with a unicornuate uterus are at a higher risk for pregnancy loss and obstetrical complications. Cause The uterus is normally formed ...
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Hysterosalpingogram
Hysterosalpingography (HSG), also known as uterosalpingography, is a radiologic procedure to investigate the shape of the uterine cavity and the shape and patency of the Fallopian tubes. It is a special x-ray using dye to look at the womb (uterus) and Fallopian tubes. It injects a radio-opaque material into the cervical canal, and usually fluoroscopy with image intensification. A normal result shows the filling of the uterine cavity and the bilateral filling of the Fallopian tube with the injection material. To demonstrate tubal rupture, spillage of the material into the peritoneal cavity needs to be observed. Hysterosalpingography has vital role in treatment of infertility, especially in the case of fallopian tube blockage. Uses HSG is considered a diagnostic procedure. It is used in the workup of infertile females to assess the patency of fallopian tubes, assess the competency of the cervix or congenital abnormality of the uterus in multiple miscarriages, assess the patency o ...
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Bicornuate Uterus
A bicornuate uterus or bicornate uterus (from the Latin ''cornū'', meaning "horn"), is a type of mullerian anomaly in the human uterus, where there is a deep indentation at the fundus (top) of the uterus. Pathophysiology A bicornuate uterus develops during embryogenesis. It occurs when the proximal (upper) portions of the paramesonephric ducts do not fuse, but the distal portions that develops into the lower uterine segment, cervix, and upper vagina fuse normally. Diagnosis Diagnosis of bicornuate uterus typically involves imaging of the uterus with 2D or 3D ultrasound, hysterosalpingography, or magnetic resonance imaging (MRI). On imaging, a bicornuate uterus can be distinguished from a septate uterus by the angle between the cornua (intercornual angle): less than 75 degrees in a septate uterus, and greater than 105 degrees in a bicornuate uterus. Measuring the depth of the cleft between the cornua (fundal cleft) may also assist in diagnosis; a cleft of over is indicativ ...
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Premature Birth
Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 28 and 32 weeks, early preterm birth occurs between 32 and 36 weeks, late preterm birth is between 34 and 36 weeks' gestation. These babies are also known as premature babies or colloquially preemies (American English) or premmies (Australian English). Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes and/or the leaking of fluid from the vagina before 37 weeks. Premature infants are at greater risk for cerebral palsy, delays in development, hearing problems and problems with their vision. The earlier a baby is born, the greater these risks will be. The cause of spontaneous preterm birth is often not known. Risk factors include diabetes, high blood pressure, multiple gestation (being pregna ...
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Miscarriage
Miscarriage, also known in medical terms as a spontaneous abortion and pregnancy loss, is the death of an embryo or fetus before it is able to survive independently. Miscarriage before 6 weeks of gestation is defined by ESHRE as biochemical loss. Once ultrasound or histological evidence shows that a pregnancy has existed, the used term is clinical miscarriage, which can be ''early'' before 12 weeks and ''late'' between 12-21 weeks. Fetal death after 20 weeks of gestation is also known as a stillbirth. The most common symptom of a miscarriage is vaginal bleeding with or without pain. Sadness, anxiety, and guilt may occur afterwards. Tissue and clot-like material may leave the uterus and pass through and out of the vagina. Recurrent miscarriage (also referred to medically as Recurrent Spontaneous Abortion or RSA) may also be considered a form of infertility. Risk factors for miscarriage include being an older parent, previous miscarriage, exposure to tobacco smoke, obesity, dia ...
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Hysteroscopy
Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention (operative hysteroscopy). Hysteroscope A hysteroscope is an endoscope that carries optical and light channels or fibers. It is introduced in a sheath that provides an inflow and outflow channel for insufflation of the uterine cavity. In addition, an operative channel may be present to introduce scissors, graspers or biopsy instruments. A hysteroscopic resectoscope is similar to a transurethral resectoscope and allows entry of an electric loop to shave off tissue, for instance to eliminate a fibroid. A ''contact hysteroscope'' is a hysteroscope that does not use distention media. Procedure Hysteroscopy has been carried out in hospitals, surgical centers and doctors' offices. It is best carried out when the endometrium is relatively thin, that is after a menstruation. Both diagnosti ...
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Hysterosalpingography
Hysterosalpingography (HSG), also known as uterosalpingography, is a radiologic procedure to investigate the shape of the uterine cavity and the shape and patency of the Fallopian tubes. It is a special x-ray using dye to look at the womb (uterus) and Fallopian tubes. It injects a radio-opaque material into the cervical canal, and usually fluoroscopy with image intensification. A normal result shows the filling of the uterine cavity and the bilateral filling of the Fallopian tube with the injection material. To demonstrate tubal rupture, spillage of the material into the peritoneal cavity needs to be observed. Hysterosalpingography has vital role in treatment of infertility, especially in the case of fallopian tube blockage. Uses HSG is considered a diagnostic procedure. It is used in the workup of infertile females to assess the patency of fallopian tubes, assess the competency of the cervix or congenital abnormality of the uterus in multiple miscarriages, assess the patency o ...
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Sonohysterography
Gynecologic ultrasonography or gynecologic sonography refers to the application of medical ultrasonography to the female pelvic organs (specifically the uterus, the ovaries, and the fallopian tubes) as well as the bladder, the adnexa, and the recto-uterine pouch. The procedure may lead to other medically relevant findings in the pelvis.This technique is useful to detect myomas or mullerian malformations. Routes The examination can be performed by transabdominal ultrasonography, generally with a full bladder which acts as an acoustic window to achieve better visualization of pelvis organs, or by transvaginal ultrasonography with a specifically designed vaginal transducer. Transvaginal imaging utilizes a higher frequency imaging, which gives better resolution of the ovaries, uterus and endometrium (the fallopian tubes are generally not seen unless distended), but is limited to depth of image penetration, whereas larger lesions reaching into the abdomen are better seen trans ...
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Transvaginal Ultrasonography
Vaginal ultrasonography is a medical ultrasonography that applies an ultrasound transducer (or "probe") in the vagina to visualize organs within the pelvic cavity. It is also called transvaginal ultrasonography because the ultrasound waves go ''across'' the vaginal wall to study tissues beyond it. Uses Vaginal ultrasonography is used both as a means of gynecologic ultrasonography and obstetric ultrasonography. It is preferred over abdominal ultrasonography in the diagnosis of ectopic pregnancy. See also * Gynecologic ultrasonography Gynecologic ultrasonography or gynecologic sonography refers to the application of medical ultrasonography to the female pelvic organs (specifically the uterus, the ovaries, and the fallopian tubes) as well as the bladder, the adnexa, and the rec ... References External links * Medical ultrasonography {{medical-equipment-stub ...
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Uterus Didelphys
Uterus didelphys (sometimes also ''uterus didelphis'') represents a uterine malformation where the uterus is present as a paired organ when the embryogenetic fusion of the Müllerian ducts fails to occur. As a result, there is a double uterus with two separate cervices, and possibly a double vagina as well. Each uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary. Most non-human mammals do not have a single uterus with no separation of horns. Marsupials and rodents have a double uterus (uterus duplex). In other animals (''e.g.'' nematodes), the term 'didelphic' refers to a double genital tract, as opposed to monodelphic, with a single tract. Signs and symptoms Persons with the condition may be asymptomatic and unaware of having a double uterus. However, a study by Heinonen showed that certain conditions are more common. In his study of 26 women with a double uterus gynecological complaints included dysmenorrhea and dyspareunia. All patients dis ...
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Septate Uterus
A uterine septum is a form of a congenital malformation where the uterine cavity is partitioned by a longitudinal septum; the outside of the uterus has a normal typical shape. The wedge-like partition may involve only the superior part of the cavity resulting in an ''incomplete septum'' or a ''subseptate uterus'', or less frequently the total length of the cavity (''complete septum'') and the cervix resulting in a double cervix. The septation may also continue caudally into the vagina resulting in a " double vagina". Signs and symptoms The condition may not be known to the affected individual and not result in any reproductive problems; thus normal pregnancies may occur. In more serious cases have reported high infertility rates. However, it is associated with a higher risk for miscarriage, premature birth, and malpresentation. According to the classical study by Buttram there is a 60% risk of a spontaneous abortion, this being more common in the second than in the first trimeste ...
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Uterine Malformation
A uterine malformation is a type of female genital malformation resulting from an abnormal development of the Müllerian duct(s) during embryogenesis. Symptoms range from amenorrhea, infertility, recurrent pregnancy loss, and pain, to normal functioning depending on the nature of the defect. Types The American Fertility Society (now American Society of Reproductive Medicine) Classification distinguishes: ; Class I—Müllerian agenesis (absent uterus). : This condition is represented by the hypoplasia or the agenesis (total absence) of the different parts of the uterus: :* Vaginal hypoplasia or agenesis :* Cervical hypoplasia or agenesis :* Fundal hypoplasia or agenesis (absence or hypoplasia of the fundus of the uterus) :* Tubal hypoplasia or agenesis (absence or hypoplasia of the Fallopian tubes) :* Combined hypoplasia the agenesis of different part of the uterus :This condition is also called Mayer-Rokitansky-Kuster-Hauser syndrome. The patient with MRKH syndrome will hav ...
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Arcuate Uterus
The arcuate uterus is a form of a uterine anomaly or variation where the uterine cavity displays a concave contour towards the fundus. Normally the uterine cavity is straight or convex towards the fundus on anterior-posterior imaging, but in the arcuate uterus the myometrium of the fundus dips into the cavity and may form a small septation. The distinction between an arcuate uterus and a septate uterus is not standardized. Signs and symptoms The condition may not be known to the affected individual and not result in any reproductive problems; thus normal pregnancies occur. Indeed, there is no consensus on the relationship of the arcuate uterus and recurrent pregnancy loss. Accordingly, the condition may be a variation or a pathology. One view maintains that the condition is associated with a higher risk for miscarriage, premature birth, and malpresentation. Thus a study that evaluated women with uterine bleeding by hysteroscopy found that 6.5% of subjects displayed the arcuate ut ...
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