CONGENITAL

MALFORMATION OF THE
FEMALE GENITAL TRACT
Dr. H. AMIR FAUZI, SpOG(K)

 GENITOURINARY DEVELOPMENT
OCCURS IN FIRST TRIMESTER
NEARLY COMPLETE AT THE END OF
THE FIRST TRIMESTER
EXCEPT FINAL CANALIZATION OF THE
VAGINA AND REPOSITIONING OF
GONAD

 FORMATION OF THE THREE PRIMARY

GERM LAYERS:
ECTODERM
MESODERM
ENDODERM
FOLLOWED BY THE LATERAL FOLDING
INTO A CYLINDRIC EMBRYO

 CYLINDRIC EMBRYO CONTAINS A PRIMITIVE

GUT AND BODY CAVITY
GUT SUSPENDED WITHIN THE CELOMIC
CAVITY LATERAL FOLDING (TWO
ELONGATED RIDGES) UROGENITAL
RIDGES
UROGENITAL CONTAIN: MESENCHYMAL
PRECURSOR OF GENITAL AND URINARY
SYSTEM, EXCEPT EXTERNAL GENITALIA,
LOWER VAGINA, URETHRA AND BLADDER

 THE ORIGIN OF UTERUS, OVARIES

AND MOST OF VAGINA ARE
MESODERMAL
THE UROGENITALIS BECOMES
MESONEPHRIC DUCTS AND CALLED
AS THE WOLFFIAN DUCTS,
PARAMESONEPHRIC DUCTS ARE
CALLED THE MULLERIAN DUCTS

MESONEPHRIC DUCT
(WOLFFIAN DUCT)
MESONEPHRIC TUBULES, GLOMERULI AND
DUCT FORM LONG THE LATERAL SIDE OF
UROGENITAL RIDGE
THE DUCTS RUN TO UROGENITAL SINUS
AND GIVES OF A BUD (URETERIC BUD),
MESONEPHRIC GLOMERULI TUBULES
DISAPPEAR
THE URETERIC BUD FORM CALYCES AND
URETER, AT THE LOWER END OF
UROGENITAL RIDGE THE BUD INDUCED OF
METANEPHROS AND WILL FORM CORTEX
AND MEDULLA OF THE ADULT KIDNEY

 DISTAL PORTIONS OF MESONEPHRIC DUCT

ORIFICES INTO THE UROGENITAL SINUS AND FORM
BLADDER AND URETHA THAT ORIFICES TO THE
VESTIBULE OF THE UROGENITAL SINUS
THE FAILURE OF GROWTH ARE:
RENAL AGENESIS
DUPLICATION OF URETER
PELVIC KIDNEY
PARAOVARIAN CYSTS
PARATUBAL CYSTS
GARTNER DUCT CYSTS
ECTOPIC OPENING OF URETER TO VAGINA

PARAMESONEPHRIC
(MULLERIAN) DUCT

THE LOWER END OF PARAMESONEPHRIC DUCT PROLIFERATES AND

INVAGINATES THE POSTERIOR WALL OF UROGENITAL SINUS AND
CALLED THE MULLERIAN TUBERCLE
THE VERTICAL PORTION FORM ENDOMETRIUM AND ENDOCERVIX
THE CRANIAL END BECOME THE FALLOPIAN TUBES
THE INFERIOR PART GROWTH TO FORM THE UPPER TWO THIRDS
OF THE VAGINA
SINUS UROGENITAL CONTACT WITH MULLERIAN TUBERCLE
PROLIFERATES AND FORMS SINOVAGINAL BULBS
THE BULBS GROWTH UP AND FORMS THE LOWER THIRD OF VAGINA
CAUDAL GROWTH OF UROGENITAL SINUS BECOMES VAGINAL
VESTIBULES
JUNCTION OF DEVELOPING VAGINA WITH THE UROGENITAL SINUS
CALLED HYMEN

 THE PARAMESONEPHRIC DUCTS FAIL

TO FORM :
VAGINAL ATRESIA
DUPLICATIONS OF THE UTERUS IN
VAGINA

SPECIFIC ANOMALIES
EXTERNAL GENITALIA
CONGENITAL FUSION OF LABIA MINORA
COMPLEX GENETIC SYNDROMES
CLITORAL HYPERTROPY
HYMEN
IMPERFORATE HYMEN
TRANSVERSE VAGINAL SEPTUM
LONGITUDINAL VAGINAL SEPTUM
MULLERIAN FUSION DEFECTS
INCOMPLETE FUSION (SMALL SEPTATE TO COMPLETE
DUPLICATION OF UTERUS)
ABSENCE OF UTERUS AND VAGINA
MAYER-ROKITANSKY-KUSTER-HAUSER SYNDROME