Müllerian duct anomalies: Embryological development, classification, and MRI assessment

Robbins, Jessica B.; Broadwell, Christy; Chow, Laurence C.; Parry, John; Sadowski, Elizabeth A.

doi:10.1002/jmri.24771

Cited by 77 publications

(79 citation statements)

References 43 publications

(105 reference statements)

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“…It is classified as type III Mullerian duct anomaly (MDA) associated by mesonephric duct anomaly. It accounts for approximately 5% of MDAs [4,5]. …”

Section: Discussionmentioning

confidence: 99%

The Herlyn-Werner-Wunderlich Syndrome – A Case Report with Radiological Review

Khaladkar

Kamal

et al. 2016

Pol J Radiol

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SummaryBackgroundHWW syndrome is a very rare congenital anomaly of urogenital tract involving Mullerian ducts and mesonephric ducts. It is characterised by a triad of symptoms - uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis. It can be classified based on a completely or incompletely obstructed hemivagina. It presents soon after menarche or shows delayed presentation depending on the type. It can exhibit acute pelvic pain shortly after menarche and may show non-specific and variable symptoms with resultant delay in diagnosis. The most common presentation is pain and dysmenorrhea, and pain and abdominal mass in the lower abdomen secondary to haematocolpos and/or haematometra.Case ReportPresentation of a clinical case of a 13-year-old patient with HWW syndrome presenting with regular menses, dysmenorrhea and painful lump in hypogastric region on the left side of midline. We described the role of imaging modalities in diagnosis of the Herlyn-Werner-Wunderlich syndrome with a review of literature. USG and MRI showed left renal agenesis with compensatory hypertrophy of the right kidney, uterus didelphys with haematometra and haematocervix in the left uterus with evidence of blood in a dilated retort-shaped left fallopian tube and a normal right uterus. The unique feature of our case is haematometra and haematocervix with cervical and vaginal atresia found on the left side (classification 1.2) with associated left renal agenesis.ConclusionsHWW syndrome can present early or late, depending on the type. In patients with uterine and vaginal abnormalities, a work-up for associated renal anomalies should be performed. Early intervention is needed to reduce the risk of endometriosis and infertility.

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“…It is classified as type III Mullerian duct anomaly (MDA) associated by mesonephric duct anomaly. It accounts for approximately 5% of MDAs [4,5]. …”

Section: Discussionmentioning

confidence: 99%

The Herlyn-Werner-Wunderlich Syndrome – A Case Report with Radiological Review

Khaladkar

Kamal

et al. 2016

Pol J Radiol

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“…Besides, no signs of laceration, effusion or lesions and no uterine anomalies were observed during the cesarean section. Based on current literature, we consider the mechanism involved in this case may be Mullerian duct dysplasia, which is the primary cause for the development of congenital uterine anomalies related to gene abnormities, environment factors, radiational exposure, steroid hormones disorders and so on …”

Section: Discussionmentioning

confidence: 99%

Herniation of the amniotic sac through congenital uterine defect confirmed during operation: A case report

Sun

Liu

et al. 2018

J of Obstet and Gynaecol

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Herniation of the amniotic sac into the peritoneal cavity or bladder is a rare but serious condition during pregnancy, which has not been reported in pored congenital uterine anomaly. Here, we report a rare case to draw obstetricians' attention to the atypical uterine rupture. A primigravida at 35 weeks of gestation was admitted for upper abdominal pain. A primary diagnosis of uterine rupture was made after finding the amniotic sac herniation through obstetric ultrasound. Exploration during emergent cesarean section revealed symmetrical pored defect on the uterine horn. The diagnosis of uterine anomaly was eventually made. The educational meaning of this rare case is that it is advisable to rule out uterine anomalies when signs of uterine rupture are suspected during pregnancy while contributory risk factors have not been identified. Besides, it is of vital importance to make a full assessment of both the mother and the fetus so to determine the appropriate time of termination.

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“…Although two-dimensional (2D) ultrasound is the most commonly used imaging method in pregnancy, it is also the least accurate in diagnosing PD abnormalities 6. Compared with hysteroscopy, the sensitivity of 2D ultrasound in detecting PD abnormalities was 56%6 likely due to difficulty visualising the outer contours of the uterine fundus 36. In comparison, 3D ultrasound and MRI are each reported to have a sensitivity of 100% in diagnosing PD abnormalities 6 37.…”

Section: Discussionmentioning

confidence: 99%

Vaginal birth after two previous caesarean deliveries in a patient with uterus didelphys and an interuterine septal defect

Ng’ang’a¹,

Ratzersdorfer

Abdelhak

2017

BMJ Case Reports

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Uterus didelphys is a congenital abnormality characterised by double uteri, double cervices and a double or single vagina that affects 0.3% to 11% of the general female population. A 23-year-old woman, gravida 3 para 3003, with uterus didelphys, acquired an iatrogenic interuterine septal defect during an otherwise routine primary caesarean delivery for fetal malpresentation. The defect was repaired but noted to have dehisced during her second pregnancy. A repeat caesarean section was performed due to fetal malpresentation after an unsuccessful external cephalic version. The dehisced defect was left unrepaired. During her third pregnancy, the placenta implanted in the right uterus, but the fetus migrated to the left uterus at approximately 28 weeks gestation. The umbilical cord traversed the interuterine septal defect. With the fetus in the vertex presentation at term gestation, the patient underwent a vaginal birth after two previous caesarean deliveries without any major perinatal complications.

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Müllerian duct anomalies: Embryological development, classification, and MRI assessment

Cited by 77 publications

References 43 publications

The Herlyn-Werner-Wunderlich Syndrome – A Case Report with Radiological Review

The Herlyn-Werner-Wunderlich Syndrome – A Case Report with Radiological Review

Herniation of the amniotic sac through congenital uterine defect confirmed during operation: A case report

Vaginal birth after two previous caesarean deliveries in a patient with uterus didelphys and an interuterine septal defect

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