Non-Obstructive Müllerian Anomalies

Congenital Uterine Anomalies and Uterine Rupture

“…The process of genital tract formation is controlled by genes that are regulated by steroid hormones, so disruption of normal timing, or exposure to an endocrine disruptor, has been implicated as the etiology for some congenital uterine anomalies . Most researchers believe the majority of cases are multifactorial and may include epigenetic and environmental factors …”

“…Malpresentation and preterm labor may be due to the abnormal shape of the uterus, decreased uterine capacity, and abnormal myometrial contractility . Preterm labor might also be caused by asymmetric pressure on the cervix from the abnormal uterine shape and less connective tissue in the cervix .…”

“…Three‐dimensional ultrasound or magnetic resonance imaging (MRI) will likely be needed for full delineation of the anomaly . MRI has become the gold standard for evaluation of congenital uterine anomalies, with diagnostic accuracy near 100% . MRI also provides noninvasive evaluation of urinary tract structures .…”

“…This would also explain the absence of vaginal bleeding despite the severe hemorrhage that occurred at the rupture site. Had JR been diagnosed with a rudimentary horn pregnancy, the recommendation would have been to surgically remove the uterine horn at the time of diagnosis . JR's case demonstrates how difficult delineation of these anomalies can be.…”

Development of the Female Reproductive Tract and Associated Anomalies

“…When uterine aplasia is observed, it is important to further characterize the patient as the underlying syndrome will guide further management. A karyotype is essential to differentiating MRKH from AIS [9].…”