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Uterine Anomalies
Barton F. Lane, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Müllerian duct anomalies (MDA)
            • Synonyms

              • Uterine fusion anomalies
            • Definitions

              • MDA: Uterine malformations resulting from abnormal development, fusion, or resorption of müllerian ducts
                • Unicornuate, bicornuate, didelphys uterus ± cervical/vaginal malformation
              • Intercornual line: Horizontal line between distal end of uterine horns, defined in coronal plane of uterus

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • MR Findings

                  • CT Findings

                    • Fluoroscopic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Ludwin A et al: Septate uterus according to ESHRE/ESGE, ASRM and CUME definitions: association with infertility and miscarriage, cost and warnings for women and healthcare systems. Ultrasound Obstet Gynecol. 54(6):800-14, 2019
                                        2. Practice Committee of the American Society for Reproductive Medicine. Electronic address: [email protected] et al: Uterine septum: a guideline. Fertil Steril. 106(3):530-40, 2016
                                        3. Sakhel K et al: Begin with the basics: role of 3-dimensional sonography as a first-line imaging technique in the cost-effective evaluation of gynecologic pelvic disease. J Ultrasound Med. 32(3):381-8, 2013
                                        4. Behr SC et al: Imaging of müllerian duct anomalies. Radiographics. 32(6):E233-50, 2012
                                        5. Marcal L et al: Mullerian duct anomalies: MR imaging. Abdom Imaging. 36(6):756-64, 2011
                                        6. Drakonaki EE et al: Hematocolpometra due to an imperforate hymen presenting with back pain: sonographic diagnosis. J Ultrasound Med. 29(2):321-2, 2010
                                        7. Junqueira BL et al: Müllerian duct anomalies and mimics in children and adolescents: correlative intraoperative assessment with clinical imaging. Radiographics. 29(4):1085-103, 2009
                                        8. Johnston-MacAnanny EB et al: Diagnosis and treatment of a communicating uterus didelphys with an atretic hemivagina: utility of 3-dimensional and intraoperative sonography. J Ultrasound Med. 27(6):975-8, 2008
                                        9. Saravelos SH et al: Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod Update. 14(5):415-29, 2008
                                        10. Orazi C et al: Herlyn-Werner-Wunderlich syndrome: uterus didelphys, blind hemivagina and ipsilateral renal agenesis. Sonographic and MR findings in 11 cases. Pediatr Radiol. 37(7):657-65, 2007
                                        11. Sherer DM et al: Acquired hematometra and hematotrachelos in an adolescent with dysfunctional uterine bleeding. J Ultrasound Med. 25(12):1599-602, 2006
                                        12. Prada Arias M et al: Uterus didelphys with obstructed hemivagina and multicystic dysplastic kidney. Eur J Pediatr Surg. 15(6):441-5, 2005
                                        13. Warne SA et al: Long-term gynecological outcome of patients with persistent cloaca. J Urol. 170(4 Pt 2):1493-6, 2003
                                        14. 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

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Müllerian duct anomalies (MDA)
                                                  • Synonyms

                                                    • Uterine fusion anomalies
                                                  • Definitions

                                                    • MDA: Uterine malformations resulting from abnormal development, fusion, or resorption of müllerian ducts
                                                      • Unicornuate, bicornuate, didelphys uterus ± cervical/vaginal malformation
                                                    • Intercornual line: Horizontal line between distal end of uterine horns, defined in coronal plane of uterus

                                                  IMAGING

                                                  • General Features

                                                    • Ultrasonographic Findings

                                                      • MR Findings

                                                        • CT Findings

                                                          • Fluoroscopic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Ludwin A et al: Septate uterus according to ESHRE/ESGE, ASRM and CUME definitions: association with infertility and miscarriage, cost and warnings for women and healthcare systems. Ultrasound Obstet Gynecol. 54(6):800-14, 2019
                                                                              2. Practice Committee of the American Society for Reproductive Medicine. Electronic address: [email protected] et al: Uterine septum: a guideline. Fertil Steril. 106(3):530-40, 2016
                                                                              3. Sakhel K et al: Begin with the basics: role of 3-dimensional sonography as a first-line imaging technique in the cost-effective evaluation of gynecologic pelvic disease. J Ultrasound Med. 32(3):381-8, 2013
                                                                              4. Behr SC et al: Imaging of müllerian duct anomalies. Radiographics. 32(6):E233-50, 2012
                                                                              5. Marcal L et al: Mullerian duct anomalies: MR imaging. Abdom Imaging. 36(6):756-64, 2011
                                                                              6. Drakonaki EE et al: Hematocolpometra due to an imperforate hymen presenting with back pain: sonographic diagnosis. J Ultrasound Med. 29(2):321-2, 2010
                                                                              7. Junqueira BL et al: Müllerian duct anomalies and mimics in children and adolescents: correlative intraoperative assessment with clinical imaging. Radiographics. 29(4):1085-103, 2009
                                                                              8. Johnston-MacAnanny EB et al: Diagnosis and treatment of a communicating uterus didelphys with an atretic hemivagina: utility of 3-dimensional and intraoperative sonography. J Ultrasound Med. 27(6):975-8, 2008
                                                                              9. Saravelos SH et al: Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod Update. 14(5):415-29, 2008
                                                                              10. Orazi C et al: Herlyn-Werner-Wunderlich syndrome: uterus didelphys, blind hemivagina and ipsilateral renal agenesis. Sonographic and MR findings in 11 cases. Pediatr Radiol. 37(7):657-65, 2007
                                                                              11. Sherer DM et al: Acquired hematometra and hematotrachelos in an adolescent with dysfunctional uterine bleeding. J Ultrasound Med. 25(12):1599-602, 2006
                                                                              12. Prada Arias M et al: Uterus didelphys with obstructed hemivagina and multicystic dysplastic kidney. Eur J Pediatr Surg. 15(6):441-5, 2005
                                                                              13. Warne SA et al: Long-term gynecological outcome of patients with persistent cloaca. J Urol. 170(4 Pt 2):1493-6, 2003
                                                                              14. 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