Introduction: Uterine malformation in general population is around 7% - 8%. Abnormal fusion of the para-mesonephric duct (mullerian duct) during embryonic life results in a variety of congenital uterine malformations,...Introduction: Uterine malformation in general population is around 7% - 8%. Abnormal fusion of the para-mesonephric duct (mullerian duct) during embryonic life results in a variety of congenital uterine malformations, such as uterus didelphys, uterus bicornis bicollis, uterus bicornis unicollis, uterus subseptae, uterus arcuatus, uterus unicornis. The bicornuate uterus accounts for approximately 10% of the mullerian anomalies. Women with bicornuate uterus have no extra uterine infertility issues. The uterine malformations are known to be associated with spontaneous miscarriages, intrauterine growth restriction, preterm deliveries, preterm prelabour rupture of membranes, breech presentation and increased rate of caesarean delivery. The rates of spontaneous abortion and premature delivery have been reported to reflect the degree of non fusion of the horns. The common complications and adverse reproductive outcomes associated with bicornuate uterus are recurrent pregnancy loss (25%), preterm birth (15% - 25%) and cervical insufficiency (38%). We reported a case of bicornuate unicollis pregnancy which was infertility treated and carried till 38 weeks and had a good outcome. Case Report: A 32-year-old nullipara presented to Infertility OPD at NIMS Medical College and Hospital with the chief complaint of inability to conceive in spite of having regular sexual intercourse for 12 years without using any contraception. Patient was then investigated, bicornuate uterus identified. Infertility treatment was done by Intrauterine Insemination (IUI). Patient conceived and pregnancy continued till term uneventfully. Discussion: The prevalence of uterine anomalies is 7% - 8%. And now because of better availability of diagnostic modalities, better detection of such anomalies is possible. Bicornuate uterus is a congenital uterine anomaly that results from defective lateral fusion of the paramesonephric ducts at about the tenth week of intrauterine life around the fundus. A bicornuate uterus consists of two symmetric cornua that are fused caudad, with communication of the endometrial cavities—most often at the level of the uterine isthmus. In a partial bicornuate unicollis uterus the intervening cleft is of variable length. Bicornuate uterus has been reported to have the highest prevalence of cervical incompetence among mullerian anomalies. Prophylactic placement of cervical cerclage in selected patients has been reported to increase fetal survival rates.展开更多
Uterine anomalies account for about 4% in the most sampled population. Here we report a case of a 35 years old woman with occasional complaint of suprapelvic “heaviness”. She had an abnormal menstrual circle for the...Uterine anomalies account for about 4% in the most sampled population. Here we report a case of a 35 years old woman with occasional complaint of suprapelvic “heaviness”. She had an abnormal menstrual circle for the last 6 years. Manual palpitations were unrevealing and she appeared externally healthy. HSG was earlier performed as part of a fertility intervention (wrongly concluding on a detached form of pedunculated-myoma). Ultrasound revealed 2 separated fundal-cones, uterine cavities and a single inferior cervix. Cyesis in the bicornuate uterus is usually high-risk, making patients with uterine anomalies prone to proven misdiagnosis (e.g. appendicitis) and infertility. In addition, sonar further showed bilateral ovarian torsion. Corrective surgery was done in a hospital;post surgical healing was normal and uneventful.展开更多
MüLLERIAN duct anomalies （MDA） are abnor- malities occurring in the müllerian duct due to abnormal development of the uterus, cervix and vagina. Reported prevalence of this malformation in general populati...MüLLERIAN duct anomalies （MDA） are abnor- malities occurring in the müllerian duct due to abnormal development of the uterus, cervix and vagina. Reported prevalence of this malformation in general population was 4%-5%. But real figure may be greater because of unawareness of these diseases due to its asymptomatic nature.展开更多
Congenital anomalies of the female reproductive tract may involve the uterus, cervix, fallopian tubes, or vagina. Depending on the specific defect, a woman’s obstetric and gynecologic health may be adversely affected...Congenital anomalies of the female reproductive tract may involve the uterus, cervix, fallopian tubes, or vagina. Depending on the specific defect, a woman’s obstetric and gynecologic health may be adversely affected. In the present series patients presenting in the outpatient department with diagnosed Mullerian abnormalities were classified into several categories based on their presenting complaints. These patients were offered proper judicious management and were followed up as required. After one year of study period it was clear that most of these patients (barring a few exceptions) were treated optimally and they could live a healthy lifestyle thereafter.展开更多
文摘Introduction: Uterine malformation in general population is around 7% - 8%. Abnormal fusion of the para-mesonephric duct (mullerian duct) during embryonic life results in a variety of congenital uterine malformations, such as uterus didelphys, uterus bicornis bicollis, uterus bicornis unicollis, uterus subseptae, uterus arcuatus, uterus unicornis. The bicornuate uterus accounts for approximately 10% of the mullerian anomalies. Women with bicornuate uterus have no extra uterine infertility issues. The uterine malformations are known to be associated with spontaneous miscarriages, intrauterine growth restriction, preterm deliveries, preterm prelabour rupture of membranes, breech presentation and increased rate of caesarean delivery. The rates of spontaneous abortion and premature delivery have been reported to reflect the degree of non fusion of the horns. The common complications and adverse reproductive outcomes associated with bicornuate uterus are recurrent pregnancy loss (25%), preterm birth (15% - 25%) and cervical insufficiency (38%). We reported a case of bicornuate unicollis pregnancy which was infertility treated and carried till 38 weeks and had a good outcome. Case Report: A 32-year-old nullipara presented to Infertility OPD at NIMS Medical College and Hospital with the chief complaint of inability to conceive in spite of having regular sexual intercourse for 12 years without using any contraception. Patient was then investigated, bicornuate uterus identified. Infertility treatment was done by Intrauterine Insemination (IUI). Patient conceived and pregnancy continued till term uneventfully. Discussion: The prevalence of uterine anomalies is 7% - 8%. And now because of better availability of diagnostic modalities, better detection of such anomalies is possible. Bicornuate uterus is a congenital uterine anomaly that results from defective lateral fusion of the paramesonephric ducts at about the tenth week of intrauterine life around the fundus. A bicornuate uterus consists of two symmetric cornua that are fused caudad, with communication of the endometrial cavities—most often at the level of the uterine isthmus. In a partial bicornuate unicollis uterus the intervening cleft is of variable length. Bicornuate uterus has been reported to have the highest prevalence of cervical incompetence among mullerian anomalies. Prophylactic placement of cervical cerclage in selected patients has been reported to increase fetal survival rates.
文摘Uterine anomalies account for about 4% in the most sampled population. Here we report a case of a 35 years old woman with occasional complaint of suprapelvic “heaviness”. She had an abnormal menstrual circle for the last 6 years. Manual palpitations were unrevealing and she appeared externally healthy. HSG was earlier performed as part of a fertility intervention (wrongly concluding on a detached form of pedunculated-myoma). Ultrasound revealed 2 separated fundal-cones, uterine cavities and a single inferior cervix. Cyesis in the bicornuate uterus is usually high-risk, making patients with uterine anomalies prone to proven misdiagnosis (e.g. appendicitis) and infertility. In addition, sonar further showed bilateral ovarian torsion. Corrective surgery was done in a hospital;post surgical healing was normal and uneventful.
文摘MüLLERIAN duct anomalies （MDA） are abnor- malities occurring in the müllerian duct due to abnormal development of the uterus, cervix and vagina. Reported prevalence of this malformation in general population was 4%-5%. But real figure may be greater because of unawareness of these diseases due to its asymptomatic nature.
文摘Congenital anomalies of the female reproductive tract may involve the uterus, cervix, fallopian tubes, or vagina. Depending on the specific defect, a woman’s obstetric and gynecologic health may be adversely affected. In the present series patients presenting in the outpatient department with diagnosed Mullerian abnormalities were classified into several categories based on their presenting complaints. These patients were offered proper judicious management and were followed up as required. After one year of study period it was clear that most of these patients (barring a few exceptions) were treated optimally and they could live a healthy lifestyle thereafter.
