Congenital GYN defects

Question 1

Your patient has an anomaly of Mullerian development (fallopian tube, uterus, cervix)

What other organ system should you check for anomalies?

Answer 1

Renal

Question 2

What is the embryologic origin of the vagina? (2)

Answer 2

Upper 1/3 of vagina = Mullerian duct

Lower 2/3 of vagina = urogenital sinus

Question 3

A patient has a unicornate uterus.

Which step in Mullerian development failed?

Answer 3

Elongation

Question 4

A patient has a didelphys uterus.

Which step in Mullerian development failed?

Describe the anatomy.

Answer 4

Complete failure of fusion

Pt will have 2 uteruses, 2 cervixes

Question 5

A patient has a bicornuate uterus.

Which step in Mullerian development failed?

Answer 5

Partial failure of fusion

Question 6

A patient has a septate uterus.

What step failed?

Describe the anatomy

Answer 6

Failure of resorption

Normal external contour of uterus fundus, with tissue dividing the inner uterine cavity

Question 7

What should cyclic pain with amenorrhea make you think of?

Answer 7

Obstruction to menstrual outflow

Question 8

A patient presents with renal abnormalities.

Should you check her ovaries?

Answer 8

No.

Ovaries develop entirely independently of Mullerian and mesonephric ducts

Question 9

Compare the reproductive implication of septate, bicornuate, and didelphys

Answer 9

• Septate: increased risk of miscarraige
• Bicornuate: increased risk of miscarraige, prematurity, malpresentation
• Didelphys: pregnancy is possible

Question 10

Compare uterus didelphys and bicornuate uterus

Answer 10

Didelphys: two cervixes

Bicornuate: one cervix