Clinical manifestations and diagnosis of congenital anomalies of the uterus
- Ronald E Iverson, Jr, MD
Ronald E Iverson, Jr, MD
- Harvard Medical School
- Alan H DeCherney, MD
Alan H DeCherney, MD
- Chief, Reproductive Biology and Medicine Branch
- National Institute of Child Health and Human Development
- National Institutes of Health
- Marc R Laufer, MD
Marc R Laufer, MD
- Professor of Obstetrics, Gynecology, and Reproductive Biology
- Harvard Medical School
Congenital anomalies of the uterus are often asymptomatic and therefore unrecognized. They may affect a young woman due to pain at the time of menarche, or a woman's obstetric and/or gynecologic health.
The classification, diagnosis, and clinical manifestations of congenital uterine anomalies will be reviewed here. Treatment of these anomalies and congenital cervical and vaginal abnormalities are discussed separately. (See "Surgical management of congenital uterine anomalies" and "Congenital cervical anomalies and benign cervical lesions" and "Diagnosis and management of congenital anomalies of the vagina".)
A classification system is an attempt to group by symptomatology, treatment, or prognosis. It is through use of standardized nomenclature that physicians can more accurately codify the symptomatology, treatment, and outcome of patients with uterine anomalies. Unfortunately, there is no universally accepted and interpreted classification system for uterine anomalies .
●The American Fertility Society in 1988 produced a standard form for classification of müllerian defects (table 1 and figure 2) . This descriptive form focuses largely on vertical fusion defects and, therefore, on uterine dysgenesis. Associated anomalies in the vagina, cervix, fallopian tubes, and renal system should also be noted.
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- Frequency of specific anomalies
- DEVELOPMENTAL DEFECTS
- Lateral fusion defects
- - Septate/arcuate uterus
- - Unicornuate uterus
- - Bicornuate uterus
- - Uterine didelphys
- Vertical fusion defects
- Diethylstilbestrol induced defects
- Associated renal anomalies
- CLINICAL MANIFESTATIONS
- Signs and symptoms
- OBSTETRICAL COMPLICATIONS
- Recurrent pregnancy loss
- Preterm delivery
- Uterine rupture
- - Three-dimensional ultrasound
- Magnetic resonance imaging
- SUMMARY AND RECOMMENDATIONS