Obstructing malformations of the uterus and vagina

Pinsonneault, Odette; Goldstein, Donald P.

doi:10.1016/s0015-0282(16)48745-5

Cited by 48 publications

(3 citation statements)

References 4 publications

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“…18 Among 16 cases of obstructing malformations of the uterus and vagina operated at The Children's Hospital, Harvard Medical School, between 1970 and 1983, one case had her kidneys in normal position. 19 Similar to our case, there are case reports of successful term singleton as well as twin pregnancies elsewhere. 3,[20][21][22][23] Uterine anomaly is detected during infertility work up, 22 during second vaginal delivery which was missed in first vaginal birth, 20 and cases of delayed-interval-delivery of twins complicated with chorioamnionitis in uterus didelphys.…”

Section: Discussionsupporting

confidence: 85%

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Uterus didelphys with double vagina diagnosed during third cesarean section: A case report

Dorji¹,

Tshering²,

Wangden³

2022

SAGE Open Medical Case Reports

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Uterus didelphys is a rare uterine anomaly. It is associated with fetal breech presentation, preterm delivery, and cesarean section. Longitudinal vaginal septum may be associated with uterus didelphys, which may cause dyspareunia and labor obstruction. We report a case of 28-year-old woman whose uterus didelphys and longitudinal vaginal septum were diagnosed during third cesarean section. This case report highlights the importance of routine examination of adnexal structures during cesarean section, so that any unsuspected pathologies in the uterus, tubes, and ovaries are diagnosed.

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Section: Discussionsupporting

confidence: 85%

“…18 Among 16 cases of obstructing malformations of the uterus and vagina operated at The Children’s Hospital, Harvard Medical School, between 1970 and 1983, one case had her kidneys in normal position. 19…”

Section: Discussionmentioning

confidence: 99%

Uterus didelphys with double vagina diagnosed during third cesarean section: A case report

Dorji¹,

Tshering²,

Wangden³

2022

SAGE Open Medical Case Reports

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“…calibre of the cervical canal, internal cervical os stiffness, calibre of the tubal ostia, diameter and course of the intramural tubal portion, function of the utero-tubal junction, amount of menstrual flow, frequency and strength of myometrial contractions with loss of fundocervical polarity) ( Bartosik et al , 1986 ; Cramer et al , 1986 ; Barbieri et al , 1992 ; Vercellini et al , 1997 ; Barbieri, 1998 ; Leyendecker et al , 2004 ; Bulletti et al , 2002 ; Missmer et al , 2004 ; Rozewicki et al , 2005 ; Munro, 2023 ; XholLi et al , 2023 ) together with non-modifiable genetic determinants ( Liang et al , 2023 ) govern the amount of refluxed blood and endometrium per cycle in the general population of menstruators and thus contribute substantially to the chance of developing endometriosis in specific subgroups ( D’Hooghe and Debrock, 2002 ; Yovich et al , 2020 ). Indeed, endometriosis is significantly more common in patients with obstructive Müllerian anomalies than in those with non-obstructive anomalies ( Pinsonneault and Goldstein, 1985 ; Sanfilippo et al , 1986 ; Olive and Henderson, 1987 ). In addressing the question ‘ Why do not all women develop endometriosis?…”

Section: Criticisms Of the Repetitive Ovulatory Menstruation Hypothesismentioning

confidence: 99%

Proposal for targeted, neo-evolutionary-oriented, secondary prevention of early-onset endometriosis and adenomyosis. Part I: pathogenic aspects

Vercellini,

Bandini,

Viganò

et al. 2023

Human Reproduction

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The potential for repeated ovulation and menstruation is thought to have provided a Darwinian advantage during the Palaeolithic. Reproductive conditions remained relatively stable until the pre-industrial era, characterized by late menarche, very young age at first birth, multiple pregnancies, and prolonged periods of lactational amenorrhoea. For hundreds of thousands of years, menstruators experienced few ovulatory cycles, even though they were genetically adapted to ovulate and menstruate every month. In the post-industrial era, the age at menarche gradually declined, the age at first birth progressively increased, and breastfeeding became optional and often of short duration. This created a mismatch between genetic adaptation and socio-environmental evolution, so that what was initially a probable reproductive advantage subsequently contributed to increased susceptibility to diseases associated with lifetime oestrogen exposure, such as ovarian, endometrial and breast cancer and, hypothetically, also those associated with the number of ovulatory menstruations, such as endometriosis and adenomyosis. The incidence of endometriosis shows a steep and progressive increase around the age of 25 years, but given the consistently reported delay in diagnosis, the actual incidence curve should be shifted to the left, supporting the possibility that the disease has its roots in adolescence. This raises the question of whether, from an evolutionary point of view, anovulation and amenorrhoea should not still be considered the physiological state, especially in the postmenarchal period. However, an increase in the frequency of endometriosis in recent decades has not been demonstrated, although this deserves further epidemiological investigation. In addition, as endometriosis occurs in a minority of individuals exposed to retrograde menstruation, other important pathogenic factors should be scrutinised. Research should be resumed to explore in more detail the transtubal reflux of not only blood, but also endometrial cells, and whether they are systematically present in the peritoneal fluid after menstruation. If repetitive ovulatory menstruation during the early reproductive years is shown to increase the risk of endometriosis and adenomyosis development and progression in susceptible individuals, hormonal interventions could be used as secondary prevention in symptomatic adolescents.

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