UTERINE

ABNORMALITIES
Submitted by: Submitted
To:
Simran Anand(24) Resp. Mrs. Laxmi
Ma’am
BSc.(H)Nursing 4th year Faculty
 CONTENT

 INTRODUCTION
 DEFINITION
 INCIDENCE
 ETIOLOGY
 CLASSIFICATION OF UTERINE ABNORMALITIES
 DIAGNOSTIC MEASURES
 COMPLICATION
 MANAGEMENT
 INTRODUCTION
• Uterine abnormalities are malformations of the uterus that develop during
embryogenic life. Uterine abnormalities occur in less then 5% of all
women, but have been noted in upto 25% of women who have had
miscarriages and/or deliveries of premature babies.
• When a women is in her mother’s womb, her uterus develops as to separate
halves that fuse together before she is born. When a womens uterus develops
differently from most women, it is called uterine anomaly.
 DEFINITION
 A uterine abnormalities is a type of female genital malformation
resulting from an abnormal development of Mullerian ducts
during embryogenesis.
 Symptoms range from amenorrhoea, infertility, recurrent pregnancy
loss, and pain, to normal functioning depending on the nature of the
defect.
 INCIDENCE
•The prevalence of uterine malformation is estimated to be 6.7% in the general
population, slightly higher 7.3% in the infertility population, and significantly higher in a
population of women with the history of recurrent miscarriages( 16%).
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 Distribution : 7% arcuate,
34% septate, 39%
bicornuate, 11%
didelphic, 5% unicornuate,
hypoplastic and other forms. 4%
ETIOLOGY
1.Genetic cause
2.No any other causes at this time
is present
 AMERICAN FERTILITY SOCIETY
CLASSIFICATION----
TYPES  Class 1: Hypoplasia uterus or Agenesis:
Segmental or complete (absent
uterus).
 Class2: Unicornuate uterus with or
without rudimentary horn (a one-
sided uterus).
 Class3: Didelphus uterus also uterus
didelphis (double uterus) .
 Class4: Bicornuate uterus: Complete or
partial ( uterus with two horns).
 Class5: Septate uterus: Complete or partial
(uterine septum or partition).
 Class6: Arcuate uterus: There is a concave
dimple in the uterus fundus within the
cavity
 Class7: Des related uterus: The uterine
cavity has a “t-shaped” as a result of
 o CLASS 1: VAGINAL AGENESIS/ HYPOPLASIA--
It is characterised by an absence or hypoplasia of the
uterus, proximal vagina and sometimes the fallopian
tube.
 Diagnosed at the age of 15-18 yr
 Assessment and physical
examination
 Treatment : Surgical correction- Plastic surgery
 • o CLASS 2: UNICORNUATE
UTERUS--
• The unicornuate uterus forms when one
mullerian duct fail to elongate but the
another one develops normally.
• TREATMENT:
• No surgical intervention is required unless
endometrial tissue in a rudimentary horn
results in pain or a pelvic mass or
unless an incompetent cervix is suspected
during pregnancy.
 • o CLASS 3: DIDELPHUS UTERUS--
• It is a rare congenital anomaly and is a
consequence of unilateral or bilateral
mullerian duct duplication.
• It’s exact cause is unknown but it is
generally present from birth, though
often becomes noticeable after puberty .
• Diagnosis is carried out using a physical
examination alongside USG and 3D USG
more recently.
• There is no treatment as such for the
condition, but it must be managed
especially during pregnancy.
 o CLASS 4: BICORNUATE
UTERUS—
When the mullerians duct fuse
incompletely at the level of the
fundus then bicornuate formed.
The lower uterus and cervix are
completely fused resulting in 2
separate but communicating
endometrial cavities with a single
cervix and vagina.
 Pre-term birth: The rate of
preterm delivery is 15 to
25%.
 A pregnancy may not
reach full term in a bicornuate
uterus when the baby begins
to grow in either.
o CLASS UTERUS— 5: SEPTATE

 Most common form

of mullerian duct
defect .
 From
incomplete resorptionof
septum after
complete the
the fusion
medial of the
mullerian duct
 It is not consideredhas
occurred. to remove a
necessary
septum that has
caused not problems,
especially in women
who are not considering
pregnancy.
 ARCUATE UTERUS
 Characterised by a small septate
indentation the superior aspect of the
uterine cavity in the fundus.
 Many patient with an arcuate uterus will
not experience any reproductive problems
and do notrequire any surgery. In patients
with, recurrent pregnancy loss,is thought to
be caused by an arcuate uterus,hence
hysteroscopic resection can be performed.
O CLASS 7: 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.
 The uterine cavity has a “T-shape” as a
result of fetal exposure to
diethylstilbestrol.
CLINICAL FEATURES

 No any symptoms
 Difficulty in getting pregnant
 Pelvic pain
 Dysmenorrhea
 Uterine rupture during
pregnancy
 Recurrent pregnancy loss
 Concurrent renal abnormalities
 Imperforated hymen
DIAGNOSTIC MEASURES
 COMPLICATION

I. Infertility
II. Early pregnancy loss
III. Uterine rupture due to its poor
development
IV. Malpresentations
V. Prolonged obstructed labor
VI. Abortion
VII. Weak uterine action
 MANAGEMENT

1. No non-surgical treatment is present only symptomatic

treatment is done.
2. Surgical intervention is considered when a septate uterus is found.
3. Bicornuate, unicornuate and didelphic uterus rarely require surgical
management.