SEMINAR ON “ABNORMALITY IN

STRUCTURE OF UTERUS”

EMMANUEL MASIH B.SC NURSING 3RD YEAR

COLLEGE OF NURSING DHAMTARI.

INTRODUCTION

A uterine malformation is a type of female genital malformation resulting from an abnormal development of the Müllerian ducts during embryogenesis.

DEFINITION

ACC. TO WIKIPEDIA. ORGThe malformation of the female genital during embryonic stage in utero.

ACC. TO RADIOPEDIA.ORGIT IS CONGENITAL ABNORMALITIES THAT OCCUR WHEN THE MULLERIAN DUCT DO NOT DEVELOP CORRECTLY.

ANATOMY

PHYSIOLOGY PROVIDE SUITABLE ENVIORNMENT FOR

DEVELOPMENT OF EMBRYO. REGULATION OF MENSTURATION CYCLE.

ETIOLOGY

1. GENETIC CAUSE 2. DIETHYLSTILBESTROL TREATMENT3. NO ANY OTHER CAUSES AT THIS TIME

IS PRESENT.

TYPESCLASS – I – HYPOPLASIA/AGENESISCLASS –II – UNICORNUATECLASS – III – DIDELPHUSCLASS – IV – BICORNUATECLASS – V – SEPTATECLASS – VI – ARCUATECLASS – VII – DES RELATED

CLASS –I VAGINAL AGENESIS/HYPOPLASIA

IT IS CHARACTERISD BY AN ABSENCE OR HYPOPLASIA OF THE UTERUS, PROXIMAL VAGINA AND SOMETIMES THE FALLOPIAN TUBE.

CLASS –II UNICORNUATE UTERUS

The unicornuate uterus forms when one Müllerian duct fail to elongate but the another one develops normally

Unicornuate uterus

CLASS – III UTERUS DIDELPHUS

IT IS A RARE CONGENITAL ANOMALY AND IS A CONSEQUENCE OF UNILATERAL OR BILATERAL MULLIERIAN DUCT DUPLICATION.

CLASS –IV BICORNUATE UTERUSWHEN THE MULLIERIAN DUCT FUSE

INCOMPLETELY AT THE LEVEL OF THE FUNDUS THEN BICORNUATE UTERUS IS FORMED.

THE LOWER UTERUS AND CERVIX ARE COMPLETELY FUSED RESULTING IN 2 SEPARATE BUT COMMUNICATING ENNDOMETRIAL CAVITIES WITH A SINGLE CERVIX AND VAGINA.

CLASS –V SEPTATE UTERUS MOST COMMON FORM OF MULLIERIAN

DUCT DEFECT. RESULT FROM INCOMPLETE RSORPTION

OF THE MEDIAL SEPTUM AFTER THE COMPLETE FUSION OF THE MULLERIAN DUCT HAS OCCURED.

CLASS – VI ARCUATE UTERUS

CHARACTERISED BY A SMALL SEPTATE INDENTATION AT THE SUPERIOR ASPECT OF THE UTERINE CAVITY IN THE FUNDUS.

CLASS –VII DES RELATED ANOMALIES

DES is a synthetic estrogen that was prescribed to women for recurrent miscarriage and premature delivery during the year 1940 – early 1970 .

“DES” UTERUS

CLINICAL MANIFESTS NO ANY SYMPTOMS DIFFICULTY IN GETTING PREGNANT PELVIC PAIN DYSMENORRHEA UTERINE RUPTURE DURING PREGNANCY RECURRENT PREGNANCY LOSS CONCURRENT RENAL ABNORMALITIES IMPERFORATE HYMEN

DIAGNOSTIC MEASURES

History taking

Physical examination

X-ray

USG

MRI

HYSTEROSCOPY

HYSTEROSALPINGOGRAPHY

COMPLICATION

I. INFERTILITYII. EARLY PREGNANCY LOSSIII. AVM

MANAGEMENT∞ NO NON-SURGICAL TREATMENT IS PRESENT

ONLY SYMPTOMATIC TREATMENT IS DONE.∞ SURGICAL INTERVENTION IS CONSIDERED WHEN

A SEPTATE UTERUS IS FOUND ∞ BICORNUATE, UNICORNUATE AND DIDELPHIC

UTERI RARELY REQUIRE SURGICAL MANAGEMENT .