IUCD, Congenital Anomalies

Question 1

Development of the Genital Ducts
Mesonephric & Paramesonephric Ducts

The development of the reproductive system is a part of prenatal development, and concerns the sex organs. It is a part of the stages of sexual differentiation. Because its location, to a large extent, overlaps the urinary system, the development of them can also be described together as the development of the _______ and ______ organs.

The reproductive organs are developed from the intermediate mesoderm in early embryonic development. The permanent organs of the adult are preceded by a set of structures which are purely embryonic, and which with the exception of the ducts disappear almost entirely before the end of fetal life.

These embryonic structures are the Wolffian Duct (Mesonephric Duct) and Müllerian Duct (Paramesonephric Duct)

The Wolffian duct remains as the duct in males, and the Müllerian duct remains as the duct in females

With the development of these ducts, if something doesn’t go as normal, it may cause congenital anomalies in both the male and females BUT especially in the female.

These anomalies can be sonographically visualized.

Answer 1

urinary

reproductive

Question 2

2 pairs of Genital Ducts develop in BOTH genders:

1) _______ (Mullerian) Ducts.
If the embryo is to become a female, mesonephric ducts regress and paramensoephric ducts will remain to form the fallopian tubes, uterus, cervix, and the upper 2/3 of the vagina.

2) _______ (Wolffian ) Ducts
If the embryo is to become a male, the paramesonephric ducts regress and the mesonephric ducts remains to form efferent ductules, epididymis, vas deferens and ejaculatory duct. The seminal vesicle develops as a diverticulum from the developing vas deferens.

Answer 2

Paramesonephric

Mesonephric

Question 3

** Genital Ducts In Summary **

Mullerian Duct
(Para-mesonephric Duct)

In the female becomes:
_____ tube
_____
_____

In the Male becomes:
_____ testis
_____ utricle

Anomalies that may occur include:
Mullerian _____= absent UT and vagina
Incomplete _____= bicornate/double UT, double vagina

Answer 3

Fallopian
Uterus
Vagina
Appendix
prostatic
agenesis
fusion

Question 4

** Genital Ducts In Summary **

Wolffian Duct
(Mesonephric Duct)

In the male becomes:
Vas _______
Vasa efferentia (tubules from the rete testis to the vas deferens and form the head of the epididymis)

In the Female becomes:
Gartner Duct Cyst
Hydatid cyst of Morgagni (a cystlike remnant of the müllerian duct on the upper end of the testis)
Epoophoron (a remnant of the Wolffian duct that can be found next to the ovary and fallopian tube)
Paroophoron (consists of a few scattered rudimentary tubules, best seen in the child, situated in the broad ligament between the epoöphoron and the uterus)

Answer 4

deferens

Question 5

Mullerian Ducts Anomalies

A wide variety of malformations can occur when the mullerian developmental system is disrupted.

Malformations range from _____ and vaginal agenesis to duplication of the UT and vagina to minor uterine cavity abnormalities i.e septum notched or divided.

Müllerian malformations are frequently associated with abnormalities of the renal and axial skeletal systems, and they are often the first encountered when patients are initially examined for associated conditions.
Most müllerian duct anomalies (MDAs) are associated with functioning ovaries and age-appropriate external genitalia.

These abnormalities are often recognized after the onset of puberty. In the prepubertal period, normal external genitalia and age-appropriate developmental milestones often mask abnormalities of the internal reproductive organs.

After the onset of puberty, young women often present to the gynecologist with menstrual disorders. Late presentations include infertility and obstetric complications.

Answer 5

uterine

Question 6

Agenesis / Atresia of the Vagina

• ________: refers to the failure of an organ to develop during embryonic growth/dev
• Atresia: is a condition in which a body orifice or passage in the body is abnormally closed

Sono Findings:
•Missing normal central vaginal opening
•Vaginal echoes
•Fluid filled endometrial cavity

Answer 6

Agenesis

Question 7

Imperforate Hymen of the Vagina
•________ - thin membrane that covers the external vagina opening

• Definition: a fold of mucous membrane which surrounds or partially covers the external vaginal opening
• Dx’d usually at onsest of menarche with bulging vaginal membrane

Sono Findings:
•Hematometrocolpos - combination of menstrual blood, fluid secretions seen w/in the UT, CX and vagina
•1st menstrual cycle begins but bc there is a closed vagina opening, the fluids can’t drain out.

Answer 7

Hymen

Question 8

Gartner’s Duct Cyst (Vaginal Cyst)

Develops from embryological remnant of the ______ duct

SONO Findings:

______ cyst on the anterio-lateral Portion of vagina

Answer 8

Anechoic