CONGENITAL ANOMALIES OF THE UTERUS

1. Double uterus and vagina(Didelphy uterus)

2. Bicornuate uterus
3. Unicornuate uterus
4. Septate uterus
5. Agenesis of the uterus(mullerian agenesis/mullerian aplasia/Rokitansky-Kuster-Hauser
syndrome)
6. Infantile uterus

These are abnormalities of the uterus that happen around 10 to the 20th week of gestation period. The
frequency of these uterine anomalies can vary,with some being more common than others. However,it’s
important to note that accurate statistics on the prevalence of these anomalies can be challenging to
determine due to variations in reporting,diagnostic criteria, and geographic differences.

DOUBLE UTERUS AND VAGINA (DIDELPHY UTERUS)

This is a condition which is as a result of the failure of the paramesonephric ducts(mullerian ducts) to
fuse in and the sinovaginal bulb forming one uterus,cervix and vagina,instead the two ducts develop into
two separate uteruses having two cervix and two distinct vaginas.

BICORNUATE UTERUS

This is one of the most common mullerian duct anomalie.It’s due to the failure of the mullerian duct to
completely fuse in,hence forming a heart shaped uterus instead of the pear shaped uterus.This can
either be complete or partial.

1. Bicollis bicornuate (complete):This is where the two mullerian duct fail to fuse in, hence forming
two uteruses and two cervix but one vagina.
2. Unicollis bicornuate(partial):This is where the two mullerian ducts partially fuses in forming two
uteruses but one cervix and vagina.

UNICORNUATE UTERUS

This is a congenital anomalie that is due to the failure in the development of the paramesonephric
ducts(mullerian ducts).Only half of the uterus is formed,the is unilateral failure of the mullerian
ducts.This can also be complete and partial failure in the development of the mullerian duct.In Complete
failure of one of the mullerian duct to develop, means it completely does not form and in another
instance it partially develops forming a rudimentary horn which is not functional(non communicating
uterus).

With this condition after puberty one can have normal menstral periods but as the rudimentary horn as
no connection with the cervix and vagina,the contractions in the horn would cause pain.

SEPTATE UTERUS

This is a condition where the two mullerian ducts fuse in but the septum bebween them does not
degenerate or rather disappear afterwards hence forming two uteruses separated by the septum,but
has one cervix and one vagina.In this anomalie the fundu is normal and only the uterus is affected.

AGENESIS OF THE UTERUS (Mullerian agenesis/Mullerian aplasia/ Rokitansky-kuster-hauser

syndrome)

This is a rare condition where the two mullerian ducts completely does not form, hence one does not
have the uterus,cervix and uterus.In a case that they develop they tend not to be fully functional and in
this situation the high presentation of this condition is primary amenorrhea(a condition where one as no
menstral priods).However, the ovaries are still present as they don’t develop from the mullerian ducts.

INFANTILE UTERUS

This is a condition where the mullrian ducts are developed and fuse in but forms an atrophied
uterus,cervix and vagina.This condition is also experienced in aged females when they reach
menopause,they possess a small uterus than normal,this can be due to the low levels of the sex
hormones(estrogen and progesterone).The vagina and ovaries are normal, Clinically presented as
amenorrhea(no menstral periods).

THE COMPLICATIONS IN PREGNANCY

Most females who tend to get pregnant have a high risk of;

 Miscarriage
 Preterm labor
 Malpresentation during labor especially in a didelphys patient.
 Increased risk of cesarean section
 Those who intend to get pregnant tend to have fertility complications, especially in a didelphys
patient as it is difficult to tell which side is ovulating during ovulation.

THE TREATMENT

 SURGERY: Surgical intervention may be necessary to correct structural abnormalitiesn or

remove obstructions.This may involve procedures such as metroplasty or removal of uterine
septum.The agenesis of the uterus is an exception, as mostly no uterus is formed.
 HORMONAL THERAPY: In some cases like infantile uterus anomalie,hormonal medications may
be prescribed to regulate the menstrual cycle and improve fertility.
 ASSISTED REPRODUCTIVE TECHNOLOGIES:For those individuals with fertility issues these
procedures such as vitro fertilization or surrogacy may be considered.