Mullerian defects

Question 1

Bilateral defect in elongation of ducts

Answer 1

Mullerian agenesis (no uterus)

Question 2

Unilateral defect in elongation of ducts

Linked with?

Answer 2

Unicornuate uterus

Renal agenesis on same side in 40%, spontaneous abortion in 50%

Question 3

Defect in fusion of ducts
Co-develop with?
Need surgery?

Answer 3

Uterine Didephylus (like having two systems- can have two cervices and septate vagina - decent reproductive rates >55%)
Co-develop with renal system
Surgery rarely needed (unless repro probs)

Question 4

Defect in canalization of ducts

Answer 4

Vaginal agenesis

Question 5

Defect in septal resorption

Answer 5

Septate uterus
MOST COMMON
V high first trimester preg loss

Question 6

Defect in fusion of Mullerian with urogenital sinus

Plus presentation and most common diagnx

Answer 6

Transverse septum (presents with abd pain, no menses - diagnx with MRI and treat poss surgery plus make a neovagina with skin graft)
Most common diagnx: imperforate hymen

Question 7

Partial horns in unicornuate uterus

Answer 7

Cavitary/communicating/non-communicating
rudimentary = cavitary with fxnl endometrium
Preg can impant in rudimentary but v high risk so horn should be removed if found earlier

Question 8

Didephylus vs Bicornuate

Answer 8

Both from fusion failure
Didephylus the two cavities do not communicate
Bicornuate has communicating endometrial cavities

Question 9

DES

Answer 9

given for spontaneous abortion and other preg problems horrible side effects in the KIDS born: MOST COMMON T-UTERUS, screen for vaginal clear cell carcinoma
males exposed in utero can also have probs