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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Müllerian duct anomaly (MDA)
Definitions
Spectrum of congenital uterine malformations
Agenesis/hypoplasia (10%)
Combined agenesis of uterus, cervix, and upper portion of vagina most common
Presents as primary amenorrhea
Unicornuate uterus (20%)
Single uterine horn; may have rudimentary horn
Uterus didelphys (5%)
2 separate, noncommunicating horns
2 cervices
Bicornuate uterus (10%)
Concave or heart-shaped external contour
2 horns with variable fusion
May have 1 cervix (bicornis unicollis) or 2 cervices (bicornis bicollis)
Septate uterus (55%)
Normal external contour
Septum may extend for variable lengths
Complete (to external os) or partial
Arcuate uterus
Argued whether this should be classified as congenital anomaly or anatomic variant
Smooth, broad, fundal indentation into cavity with normal external contour
IMAGING
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Robbins JB et al: Müllerian duct anomalies: embryological development, classification, and MRI assessment. J Magn Reson Imaging. 41(1):1-12, 2015
Sadro CT: Pictorial review of complications of uterine anomalies. Can Assoc Radiol J. 66(4):368-76, 2015
Acién P et al: Reproductive outcome in uterine malformations with or without an associated unilateral renal agenesis. J Reprod Med. 59(1-2):69-75, 2014
Dreisler E et al: Müllerian duct anomalies diagnosed by saline contrast sonohysterography: prevalence in a general population. Fertil Steril. 102(2):525-9, 2014
Paradisi R et al: The techniques and outcomes of hysteroscopic metroplasty. Curr Opin Obstet Gynecol. 26(4):295-301, 2014
Lewis AD et al: Pregnancy complications in women with uterine duplication abnormalities. Ultrasound Q. 26(4):193-200, 2010
Olpin JD et al: Imaging of müllerian duct anomalies. Clin Obstet Gynecol. 52(1):40-56, 2009
Reichman D et al: Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril. 91(5):1886-94, 2009
Erez O et al: Trial of labor and vaginal birth after cesarean section in patients with uterine Müllerian anomalies: a population-based study. Am J Obstet Gynecol. 196(6):537, 2007
Rackow BW et al: Reproductive performance of women with müllerian anomalies. Curr Opin Obstet Gynecol. 19(3):229-37, 2007
Troiano RN et al: Mullerian duct anomalies: imaging and clinical issues. Radiology. 233(1):19-34, 2004
Salim R et al: Reproducibility of three-dimensional ultrasound diagnosis of congenital uterine anomalies. Ultrasound Obstet Gynecol. 21(6):578-82, 2003
Scarsbrook AF et al: MRI appearances of mullerian duct abnormalities. Clin Radiol. 58(10):747-54, 2003
Kupesic S et al: Screening for uterine abnormalities by three-dimensional ultrasound improves perinatal outcome. J Perinat Med. 30(1):9-17, 2002
Homer HA et al: The septate uterus: a review of management and reproductive outcome. Fertil Steril. 73(1):1-14, 2000
Li S et al: Association of renal agenesis and mullerian duct anomalies. J Comput Assist Tomogr. 24(6):829-34, 2000
Propst AM et al: Anatomic factors associated with recurrent pregnancy loss. Semin Reprod Med. 18(4):341-50, 2000
No authors listed: The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil Steril. 49(6):944-55, 1988
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Müllerian duct anomaly (MDA)
Definitions
Spectrum of congenital uterine malformations
Agenesis/hypoplasia (10%)
Combined agenesis of uterus, cervix, and upper portion of vagina most common
Presents as primary amenorrhea
Unicornuate uterus (20%)
Single uterine horn; may have rudimentary horn
Uterus didelphys (5%)
2 separate, noncommunicating horns
2 cervices
Bicornuate uterus (10%)
Concave or heart-shaped external contour
2 horns with variable fusion
May have 1 cervix (bicornis unicollis) or 2 cervices (bicornis bicollis)
Septate uterus (55%)
Normal external contour
Septum may extend for variable lengths
Complete (to external os) or partial
Arcuate uterus
Argued whether this should be classified as congenital anomaly or anatomic variant
Smooth, broad, fundal indentation into cavity with normal external contour
IMAGING
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Robbins JB et al: Müllerian duct anomalies: embryological development, classification, and MRI assessment. J Magn Reson Imaging. 41(1):1-12, 2015
Sadro CT: Pictorial review of complications of uterine anomalies. Can Assoc Radiol J. 66(4):368-76, 2015
Acién P et al: Reproductive outcome in uterine malformations with or without an associated unilateral renal agenesis. J Reprod Med. 59(1-2):69-75, 2014
Dreisler E et al: Müllerian duct anomalies diagnosed by saline contrast sonohysterography: prevalence in a general population. Fertil Steril. 102(2):525-9, 2014
Paradisi R et al: The techniques and outcomes of hysteroscopic metroplasty. Curr Opin Obstet Gynecol. 26(4):295-301, 2014
Lewis AD et al: Pregnancy complications in women with uterine duplication abnormalities. Ultrasound Q. 26(4):193-200, 2010
Olpin JD et al: Imaging of müllerian duct anomalies. Clin Obstet Gynecol. 52(1):40-56, 2009
Reichman D et al: Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril. 91(5):1886-94, 2009
Erez O et al: Trial of labor and vaginal birth after cesarean section in patients with uterine Müllerian anomalies: a population-based study. Am J Obstet Gynecol. 196(6):537, 2007
Rackow BW et al: Reproductive performance of women with müllerian anomalies. Curr Opin Obstet Gynecol. 19(3):229-37, 2007
Troiano RN et al: Mullerian duct anomalies: imaging and clinical issues. Radiology. 233(1):19-34, 2004
Salim R et al: Reproducibility of three-dimensional ultrasound diagnosis of congenital uterine anomalies. Ultrasound Obstet Gynecol. 21(6):578-82, 2003
Scarsbrook AF et al: MRI appearances of mullerian duct abnormalities. Clin Radiol. 58(10):747-54, 2003
Kupesic S et al: Screening for uterine abnormalities by three-dimensional ultrasound improves perinatal outcome. J Perinat Med. 30(1):9-17, 2002
Homer HA et al: The septate uterus: a review of management and reproductive outcome. Fertil Steril. 73(1):1-14, 2000
Li S et al: Association of renal agenesis and mullerian duct anomalies. J Comput Assist Tomogr. 24(6):829-34, 2000
Propst AM et al: Anatomic factors associated with recurrent pregnancy loss. Semin Reprod Med. 18(4):341-50, 2000
No authors listed: The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil Steril. 49(6):944-55, 1988
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