Uterine Malformations: An Update of Diagnosis, Management, and Outcomes

Bhagavath, Bala; Greiner, Ellie; Griffiths, Kara M.; Winter, Tom; Alur-Gupta, Snigdha; Richardson, Carter; Lindheim, Steven R.

doi:10.1097/ogx.0000000000000444

Cited by 55 publications

(25 citation statements)

References 127 publications

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“…Reproductive outcome comprises term deliveries in 60%, cases, spontaneous abortion in 28% cases and preterm deliveries in 20% of the cases. [ 14 19 ] In this study, patients with bicornuate uterus presented with primary infertility and endometrioma in one case and ovarian malignancy in the second case. After cystectomy patient had a spontaneous conception.…”

Section: Discussionmentioning

confidence: 84%

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Management of mullerian development anomalies: 9 years' experience of a tertiary care center

Goyal

Dhaliwal

Singh

et al. 2020

Gynecol Minim Invasive Ther

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Objectives: This study aimed to analyze the clinical and imaging findings as well as the outcomes of patients with Mullerian duct anomalies. Materials and Methods: A retrospective analysis of 41 patients with Mullerian development anomalies treated in a tertiary care center in the past 9 years was done. The presenting symptoms, radiological findings, management, and the outcomes were evaluated. Results: According to the American Fertility Society's classification, 11 patients presented in Class I, 6 in Class II, and 24 in Class III of the classification. It was found that some of the defects such as the unicornuate uterus, a unicornuate uterus with noncommunicating rudimentary horn, and longitudinal vaginal septum were usually asymptomatic whereas disorders such as Mayer-Rokitansky-Küster-Hauser (MRKH), cervicovaginal atresia, and transverse vaginal septum presented with the absence of menarche, cyclical abdominal pain, and abdominal mass, respectively. Defects such as the bicornuate uterus, didelphys uterus, and septate uterus present with poor reproductive performance. Unicornuate uterus with communicating horn presented with rupture of the horn in the antenatal period, which was managed vigorously. Vaginoplasty with a skin graft and amnion graft had excellent results in MRKH syndrome. Patients with cervicovaginal atresia had a poor prognosis and ultimately required a hysterectomy. Hysteroscopic septal resection improved the reproductive performance in the patients with septate uterus. Conclusion: This study concluded that the management of uterine malformations is individualized depending on the symptoms and fertility concerns. Cervicovaginal atresia was associated with restenosis after surgery ultimately required a hysterectomy. MRKH had excellent results with McIndoe vaginoplasty. Optimal and timely management may lead to better outcomes.

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Section: Discussionmentioning

confidence: 84%

“…These patients were classified according to the classification of the American Fertility Society. [ 14 15 ]…”

Section: P Atients and M Ethodsmentioning

confidence: 99%

Management of mullerian development anomalies: 9 years' experience of a tertiary care center

Goyal

Dhaliwal

Singh

et al. 2020

Gynecol Minim Invasive Ther

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“…Although many of these anomalies have been associated with certain syndromes, most of them are not likely to be syndromic. 13 …”

Section: Discussionmentioning

confidence: 99%

<p>Laparoscopic Hysterectomy and Bilateral Salpingectomy in a Patient with Microduplication Syndrome (20p13p12.1) and a Bicornuate Uterus: An Unreported Association</p>

Pachajoa

Perafan

Ramos

et al. 2020

IJWH

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“…Characteristic findings of a unicornuate uterus in women include a small cervix and a deviated ‘banana-shaped’ uterus connected to a single oviduct. 5 , 6 Up to 70% of women with unicornuate uteruses have ipsilateral renal agenesis. 7…”

Section: Discussionmentioning

confidence: 99%

“… 11 – 15 Human literature describes unicornuate uteruses as having a single oviduct. 5 , 6 However, multiple case reports describing segmental uterine aplasia in cats have described bilateral presence of oviduct tissue. 16 , 17 Based on these reports and data presented in this case series, we suspect that cats with uterus unicornis likely do not have normal oviduct tissue, and cats with segmental aplasia likely do have normal oviduct tissue.…”

Section: Discussionmentioning

confidence: 99%

Uterus unicornis and pregnancy in two feline littermates

Brookshire

Shivley

Woodruff

et al. 2017

Journal of Feline Medicine and Surgery Open Reports

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Case series summaryA queen, tom and four 1-year-old female offspring presented for routine neuter. Two of the littermates (cats 1 and 2) were diagnosed with a uterine abnormality during surgery. The left uterine horn of both cats appeared as a thin, solid, cord-like structure, whereas the right uterine horn of both cats appeared to have intermittent bulges consistent with pregnancy. The two other littermates, queen and tom were reproductively normal. The uteruses of the affected cats were nearly identical with a gross and histopathologic diagnosis of uterus unicornis with concurrent pregnancy. Ovaries were present, bilaterally. An oviduct was present only on the single normally developed and pregnant uterine horn in both cats. At a postoperative follow-up evaluation, abdominal ultrasound was performed on the two cats with uterine abnormalities. Cat 1 was ultrasonographically within normal limits. Cat 2 was diagnosed with ipsilateral renal agenesis on the same side as the absent uterine horn.Relevance and novel informationThe complexity of uterus unicornis and renal aplasia is demonstrated by this unique presentation of five related cats for ovariohysterectomy. This report raises questions regarding the genetic, environmental, hormonal or other underlying causes of this anatomic abnormality in cats that may spur additional research. This is the first publication describing uterus unicornis in gravid feline littermates, with one of the cats having ipsilateral renal agenesis. This is also the first publication to describe oviduct agenesis on the affected uterine horn in feline uterus unicornis.

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Uterine Malformations: An Update of Diagnosis, Management, and Outcomes

Cited by 55 publications

References 127 publications

Management of mullerian development anomalies: 9 years' experience of a tertiary care center

Management of mullerian development anomalies: 9 years' experience of a tertiary care center

<p>Laparoscopic Hysterectomy and Bilateral Salpingectomy in a Patient with Microduplication Syndrome (20p13p12.1) and a Bicornuate Uterus: An Unreported Association</p>

Uterus unicornis and pregnancy in two feline littermates

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