Class 4: CG UT Anomalies Flashcards
what is another name for the mullerian ducts?
paramesonephric ducts
what do the mullerian ducts form into?
uterus, fallopian tubes, upper vagina
what is the best modality to image CG UT anomalies?
MRI
what type of U/S is best for imaging CG UT anomalies?
3-D
TV COR
TA TRV
what are the 3 causes for CG UT anomalies?
- failure of formation
- failure of fusion
- failure of median septum to dissolve
when do S&S start for CG UT anomalies?
usually around puberty – pelvic pain, dysmenorrhea, dyspareunia, delayed menstruation
what are the two types of CG UT anomalies with failure of formation?
- complete agenesis
- partial agenesis
what forms from a partial agenesis of the mullerian ducts?
unicornuate UT
what is a rudimentary horn?
when the other mullerian duct partially develops – needs to be surgically removed
what complications can arise from a rudimentary horn?
- noncommunicating: during menses, the superficial layer from the endo of the rudimentary horn will shed into the peritoneal cavity –> PID, endometriosis
- communicating: ectopic pregnancy if zygote implants into the rudimentary horn endometrium
3 types of failure of fusion of the mullerian ducts?
- complete failure = didelphys UT
- partial failure/bicornuate UT –> bicervical UT
- partial failure/bicornuate UT –> unicervical UT
what is a didelphys UT?
a duplicated system with 2 UT, 2 cx, & 2 vaginas
what is a bicervical UT?
ducts fuse at the vagina, leading to 2 UT, 2 cx, & 1 vagina
what is a unicervical UT?
ducts fuse at the cervix, leading to 2 UT, 1 cx, & 1 vagina
3 types of failure of median septum to dissolve?
- septate
- subseptate
- arcuate
what happens with a septate UT?
median septum fails to dissolve completely
duplicate endometrial cavity
what is the most common congenital anomaly of the UT?
septate UT
what is a subseptate UT?
partial failure of septum to dissolve, leading to partial duplication of the endometrial cavity
what is the least severe congenital uterine anomaly?
arcuate UT
what is an arcuate UT?
UT with an indentation at the fundal endometrium
what is a cornual ectopic pregnancy?
any pregnancy with a CG anomaly
how common are fallopian tube anomalies?
rare
what are the 3 types of FT anomalies?
- absence of FT
- doubling on 1 side
- atresia of a portion of the FT
what are the 3 types of ovarian anomalies?
- absence
- supernumerary ovaries
- accessory ovarian tissue
where can accessory ovarian tissue be found?
at the cornua or near the ovaries
where can paraovarian cysts be found?
in the broad ligament
where do paraovarian cysts arise from?
rosenmuller’s organ
what is the pedunculated type of paraovarian cyst?
hydatid cyst of margagni
what are some S&S of vaginal anomalies?
- pelvic pain
- dysmenorrhea
- dyspareunia
- delayed onset of menses
what are some causes of the S&S of vaginal anomalies?
- obstruction at UT, cx, or vag
- imperforate hymen
what is hematocolpos?
retention of blood in the vagina
what is hematometra?
retention of blood in the uterus
what is hematometrocolpos?
retention of blood in UT & vag
what is hydrometra?
fluid accumulation in the UT
hydrometra is seen more commonly with pediatric and postmenopausal patients. T/F?
true
what is pyometra?
pus accumulation in the UT
what is vaginal agenesis?
absence of vagina
what is vaginal atresia
lack of vaginal development
what can an imperforate hymen lead to?
hematocolpos
hematometra
hematometrocolpos
what type of amenorrhea is associated with an imperforate hymen?
primary amenorrhea
what is a gartner’s duct cyst?
a cyst in the anterolateral portion of the vagina
what is a gartner’s duct cyst a remnant of?
wolffian duct system
US app of gartner’s duct cyst?
simple cyst at level of vagina
what is DES?
a drug given to pregnant patients who were at risk for miscarriage; given in the 1940s-1970s
what were some consequences of DES?
- reproductive tract anomalies in the fetus
- hooded cx
- T shaped UT
- UT wall defects
- adhesions
