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Diagnosis and management of congenital anomalies of the vagina

Author
Marc R Laufer, MD
Section Editor
Robert L Barbieri, MD
Deputy Editor
Sandy J Falk, MD, FACOG

INTRODUCTION

Development of the female genital tract is a complex process dependent upon a series of events involving cellular differentiation, migration, fusion, and canalization. Failure of any one of these processes results in a congenital anomaly.

The American Society for Reproductive Medicine classifies female reproductive tract anomalies according to six groups, based upon clinical presentation and prognosis for successful pregnancy upon treatment (table 1) [1]. This classification scheme does not include nonuterine anomalies, but permits additional descriptions of associated vaginal, tubal, and urinary abnormalities.

Congenital anomalies of the vagina will be reviewed here. Congenital cervical and uterine anomalies are discussed separately. (See "Congenital cervical anomalies and benign cervical lesions" and "Clinical manifestations and diagnosis of congenital anomalies of the uterus".)

EMBRYOLOGY

The development of the female genital tract begins at three weeks of gestation and continues into the second trimester of pregnancy.

Gonads — Gonadal development results from migration of primordial germ cells to the genital ridge. At five weeks, the gonads are identical in both sexes and capable of differentiating into either an ovary or testis. The type of gonad that will develop depends upon the chromosomal sex. The first sign of ovarian differentiation is the absence of Sertoli cells at 6 to 7 weeks of gestation; the ovarian primordial follicles are identifiable after 13.5 weeks [2]. (See "Normal sexual development".)

                              

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Literature review current through: Nov 2016. | This topic last updated: Fri Sep 11 00:00:00 GMT 2015.
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