Mullerian Anomalies Flashcards
What are the Müllerian anomalies based on?
Based on prognosis for future fertility and surgical correction
How many classes of Müllerian anomalies are there?
6 different classes
What is class I?
Incomplete vaginal canalization
What is class II?
Unicornuate uterus
What is class III?
Uterus didelphys
What is class IV?
Bicornuate uterus
What is class V?
Septate uterus
What is class VI?
Diethylstibestrol (DES) exposure - T shaped uterus
CLASS I - INCOMPLETE VAGINAL CANALIZATION
What is another name for this class?
Segmental Müllerian agenesis
CLASS I - INCOMPLETE VAGINAL CANALIZATION
What 2 things can happen during this class?
Transverse vaginal septum or vaginal atresia
CLASS I - INCOMPLETE VAGINAL CANALIZATION
How will you know if a girl has a class one Müllerian anomaly?
She reaches puberty without menstruation
CLASS I - INCOMPLETE VAGINAL CANALIZATION
What is vaginal atresia?
Vagina is not fully formed
CLASS I - INCOMPLETE VAGINAL CANALIZATION
With vaginal atresia, what is hydrocolpus?
A fluid filled vagina
CLASS I - INCOMPLETE VAGINAL CANALIZATION
With vaginal atresia, what is hydrometrocolpus?
Fluid filled vagina and uterus
CLASS I - INCOMPLETE VAGINAL CANALIZATION
With vaginal atresia, what is hematometrocolpus?
Blood filled vagina and uterus
CLASS I - INCOMPLETE VAGINAL CANALIZATION
With vaginal atresia, what might be absent?
The cervix
CLASS I - INCOMPLETE VAGINAL CANALIZATION
With vaginal atresia, what can be seen during the neonatal period or diagnosed at puberty?
A large cystic pelvic mass
CLASS I - INCOMPLETE VAGINAL CANALIZATION
With vaginal atresia, the what will be imperforate?
The hymen
CLASS II - UNICORNUATE UTERUS
_________ _________ __________ of the Müllerian ducts.
Complete unilateral arrest
CLASS II - UNICORNUATE UTERUS
May have a small _______ _______ if partial arrest.
Rudimentary horn
CLASS II - UNICORNUATE UTERUS
What does the uterus look like?
Long, slender, cigar shaped
Deviated to one side
Small & lateral
CLASS II - UNICORNUATE UTERUS
What is frequently associated with this class?
Renal agenesis on the contralateral side
CLASS II - UNICORNUATE UTERUS
What can this class cause?
Infertility and pregnancy loss
CLASS III - UTERUS DIDELPHYS
_______ ________ of the Müllerian ducts
Complete nonfusion
CLASS III - UTERUS DIDELPHYS
Complete duplication of the _______, _______, & _______.
Uterus, cervix, and vagina
CLASS III - UTERUS DIDELPHYS
What problems are associated with this class?
No infertility problems
No treatment
CLASS III - UTERUS DIDELPHYS
How many endometrial echo complexes?
2
CLASS IV - BICORNUATE UTERUS
_______ _______ of the Müllerian ducts
Partial nonfusion
CLASS IV - BICORNUATE UTERUS
Duplication of the _______, common ________.
Uterus, cervix
CLASS IV - BICORNUATE UTERUS
Any problems associated with this class?
Low incident of fertility complications because of a wide cavity space
Not treated
CLASS IV - BICORNUATE UTERUS
At 12-16 weeks gestation…
Rudimentary cavity
Rupture of uterine cavity
CLASS IV - BICORNUATE UTERUS
2 of what can be visualized?
Endometrial cavities
CLASS V - SEPTATE UTERUS
What does this class look like?
2 uterine cavities closely spaces
1 fundus
Possibly 2 cervical canals or vaginal septums
CLASS V - SEPTATE UTERUS
Problems associated with this class?
HIGHEST incidence of infertility problems - can get pregnant but will have problems carrying the pregnancy
CLASS V - SEPTATE UTERUS
IMPORTANT FACT TO REMEMBER…
Most common uterine anomaly!!!
CLASS VI - DIETHYLSTILBESTROL (DES) EXPOSURE
Describe this class…
Given to women who miscarried often, fetus exposed in utero
A synthetic drug from 1970’s
CLASS VI - DIETHYLSTILBESTROL (DES) EXPOSURE
Who did this drug affect?
The daughters of the mothers who took the drug
CLASS VI - DIETHYLSTILBESTROL (DES) EXPOSURE
What does the uterus look like?
Abnormal shape and size
Uterine cavity is “T” shaped
Irregular contour
