Uterine Anomaly Classification

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Uterine congenital anomalies are a collection of dysmorphisms attributable to failure of Müllerian duct development. The Müllerian or Paramesonephric ducts are paired embryological structures that run down the sides of the urogenital ridge which in females become the Uterus and upper one third of the vagina.

7%–8% of women are thought to have a structural anomaly of the uterus. Whereas >25% of  women with recurrent spontaneous abortions may have anomalies. Some of these anomalies are not very detrimental to female reproduction, while others are very much so.

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The normal adult uterus measures approximately

7.5 cm in length, 5 cm in width and 2.5 cm thick.

It is approximately 30-40 grams in weight and divided into fundus, body and cervix.

 

The Müllerian anomalies are categorized into 7 classes with subgroups.

 

Class I: Müllerian agenesis or hypoplasia

(Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome)

absent-uterus

Varying degrees of vaginal and uterine agenesis with a prevalence of 1 in 5000 newborn females.

Class II: Unicornuate uterus

class-ii

Agenesis or hypoplasia of one of the two Müllerian ducts may have a communicating or non-communicating rudimentary horn.

prevalence 2.4-13% of all müllerian anomalies

 

Class III: Didelphys

class-iii

Failure of fusion of the Müllerian ducts along the whole uterine length 2 uterine bodies and 2 cervices

prevalence 11% of uterine malformations

 

Class IV: Bicornuate uterus

class-iv

Incomplete fusion of the uterine horns at the level of the fundus

60% of patients can expect to deliver a viable infant

 

 

Class V: Septate uterus

class-v

Absent or incomplete resorption of the uterovaginal septum.

incidence of both complete and partial uterine septi is 33.6%

 

Class VI: Arcuate uterus

class-vi

A mild indentation at the level of the fundus from a near-complete resorption of the uterovaginal septum.

Class VII: Diethylstilbestrol (DES) T-shaped uterus

class-vii

resulting from DES exposure of the patient in utero (less common since its withdrawal).

Knowing the varieties of uterine anomalies is of importance for the sonographer as these conditions can come with increased risk of pregnancy failures and other gynecological conditions.

 

Henry Suarez RDMS, RVT

 

 

References:
Acien P. Reproductive performance of women with uterine malformations. Hum Reprod 1993;8:122.

http://humupd.oxfordjournals.org/content/14/5/415.full#sec-5

http://radiologykey.com/congenital-uterine-anomalies/

http://emedicine.medscape.com/article/273534-overview#a12

http://www.medscape.com/viewarticle/471012_2

https://en.wikipedia.org/wiki/Diethylstilbestrol

 

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