Commonest uterine anomaly is: March 2007
Ans. B: Uterus Bicornis Uterine malformation is the result of an abnormal development of the Mullerian duct. Class I: Mullerian agenesis (absent uterus). - Uterus is not present, vagina only rudimentary or absent. - The condition is also called Mayer-Rokitansky-Kuster-Hauser syndrome. - The patient with MRKH syndrome will have primary amenorrhoea. Class II: unicornuate uterus (a one-sided uterus). - Only one side of the Mullerian duct forms. - The uterus has a typical "penis shape" on imaging systems. Class III: Uterus didelphys (double uterus). - Both Mullerian ducts develop but fail to fuse, thus the patient has a "double uterus". - This may be a condition with a double cervix and a vaginal paition (v.i.), or the lower Mullerian system fused into its unpaired condition. Class IV: Bicornuate uterus (uterus with two horns). - Only the upper pa of that pa of the Mullerian system that forms the uterus fails to fuse, thus the caudal pa of the uterus is normal, the cranial pa is bifurcated. - The uterus is "hea-shaped". Uterus bicornis unicolis is the most common. Class V: septated uterus (uterine septum or paition). The two Mullerian ducts have fused, but the paition between them is still present, splitting the system into two pas. - With a complete septum the vagina, cervix and the uterus can be paitioned. Usually the septum affects only the cranial pa of the uterus. - MRI is considered the preferred modality due to its multiplanar capabilities as well as its ability to evaluate the uterine contour, junctional zone, and other pelvic anatomy. - A hysterosalpingogram is not considered as useful due to the inability of the technique to evaluate the exterior contour of the uterus and distinguish between a bicornuate and septate uterus. - Class VI: DES uterus. The uterine cavity has a "T-shape" as a result of fetal exposure to Diethylstilbestrol. Arcuate uterus where there is a concave dimple in the uterine fundus within the cavity. A rudimentary uterus is a uterine remnant not connected to cervix and vagina and may be found on the other side of an unicornuate uterus. Patients with uterine abnormalities may have associated renal abnormalities including unilateral renal agenesis.
Uterus unicornis
Uterus bicornis
Uterus didelphys
Subseptate uterus