Müllerian duct anomalies: review of current management

The aim of this paper was to discuss the embryological aspects of Müllerian duct anomalies and to analyze the current diagnostic methods and therapy. Müllerian anomalies are congenital defects of the female reproductive tract resulting from failure in the development of the Müllerian ducts and their associated structures. Their cause has yet to be fully clarified, and it is currently believed to be multifactorial. Symptoms appear principally during adolescence or early adulthood, and affect the reproductive capacity of these women. When clinically suspected, investigations leading to diagnosis include imaging methods such as hysterosalpingography, ultrasonography and magnetic resonance. The classification of these malformations relates to their embryogenesis, and defines the therapy and prognosis. Müllerian anomalies consist of a wide range of defects that may vary from patient to patient. Therefore, their management must also be individual, taking anatomical and clinical characteristics into consideration, as well as the patient's wishes.

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Various Müllerian-duct anomalies in Women at Rural Tertiary Care Center of Northern India: An Observational Study

Current Women s Health Reviews ◽

10.2174/1573404817666210302153013 ◽

2021 ◽

Vol 17 ◽

Author(s):

Naina Kumar ◽

Ashu Yadav

Keyword(s):

Observational Study ◽

Rural Women ◽

Female Reproductive Tract ◽

Mullerian Duct ◽

Mullerian Anomalies ◽

Müllerian Duct ◽

Müllerian Anomalies ◽

Northern India ◽

Müllerian Duct Anomalies ◽

Mullerian Duct Anomalies

Aims: Present study was conducted to know presentations and nature of Müllerian-duct anomalies in rural women. Background: Müllerian anomalies are congenital defects of female reproductive tract resulting from faulty development and fusion of Müllerian ducts. Objectives: To identify common Müllerian anomalies, their presentation, radiological appearances, complications, associated renal anomalies in rural women of Northern India. Methods: Present observational study was conducted on 181 female patients with suspected Müllerian anomalies presenting to the outpatient department of Obstetrics and Gynecology with various complaints. Data included age, religion, menarche, previous pregnancy if any, duration of infertility, presenting complaints, type of Müllerian anomaly, incidental or symptomatic, diagnostic method, associated anomalies. Statistical analysis was done using SPSS 22.0 version software. Results: Of 181 patients, 16.5% were adolescents, 83.5% adult women with an overall mean (SD) age of 25.02 (5.96) years. Of these, 170 had true Müllerian-duct anomalies and 11 had defects other than Müllerian anomalies, hence excluded. Total 158(92.9%) patients were symptomatic and 12(7.1%) asymptomatic at presentation. The majority (75.9%) were diagnosed incidentally during their visit to the department for various complaints of which infertility (32.4%) was most common. Septate uterus (29.4%) was most common anomaly diagnosed followed by Müllerian agenesis/hypoplasia (22.9%). Around 11.2% cases had associated renal and collecting system anomalies with unilateral renal agenesis (47.4%) being most common. Conclusion: Hence, Müllerian-duct anomalies have diverse presentations and most of them are diagnosed incidentally. Other: The exact prevalence of Müllerian-duct anomalies may be high, especially in rural India due to lack of knowledge and societal pressures.

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Pregnancy in uterus didelphys delivered by caesarean section: a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175048 ◽

2017 ◽

Vol 6 (11) ◽

pp. 5166 ◽

Cited By ~ 1

Author(s):

Devyani Sawai ◽

Susheel Kumar Sharma ◽

Devashish Singh Sawai ◽

Uttkarsha Sawai ◽

Sangeeta Sharma ◽

...

Keyword(s):

Caesarean Section ◽

High Risk Group ◽

Congenital Defects ◽

Mullerian Duct ◽

Müllerian Duct ◽

Uterus Didelphys ◽

Müllerian Duct Anomalies ◽

Mullerian Anomaly ◽

Mullerian Ducts ◽

Mullerian Duct Anomalies

The aim of this study is to report a rare case of pregnancy in uterus didelphys. Mullerian duct anomalies are congenital defects of the female genital system that arise from abnormal embryological development of the Mullerian ducts. A didelphys uterus, also known as double uterus is one of the least common amongst the various Mullerian duct anomalies. It results from complete failure of fusion of Mullerian ducts. There is presence of double uterine bodies with two separate cervices and often double or septate vagina. We report the case in our institute of a pregnancy in the left sided body of a didelphys uterus, delivered by caesarean section. Patients with uterus didelphys belong to high risk group and complications are increased in malformed uterus. Such cases need a meticulous prenatal care. It is a rare Mullerian anomaly and can present with varied obstetrical and gynaecological complications. Prompt and accurate diagnosis of uterine malformations and appropriate surgical intervention are essential to prevent complications.

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Studying Müllerian duct anomalies – from cataloguing phenotypes to discovering causation

Disease Models & Mechanisms ◽

10.1242/dmm.047977 ◽

2021 ◽

Vol 14 (6) ◽

Author(s):

Laura Santana González ◽

Mara Artibani ◽

Ahmed Ashour Ahmed

Keyword(s):

Developmental Disorders ◽

New Technologies ◽

Association Studies ◽

Female Reproductive Tract ◽

Mullerian Duct ◽

Female Population ◽

Müllerian Duct ◽

Familial Cases ◽

Müllerian Duct Anomalies ◽

Mullerian Duct Anomalies

ABSTRACT Müllerian duct anomalies (MDAs) are developmental disorders of the Müllerian duct, the embryonic anlage of most of the female reproductive tract. The prevalence of MDAs is 6.7% in the general female population and 16.7% in women who exhibit recurrent miscarriages. Individuals affected by these anomalies suffer from high rates of infertility, first-trimester pregnancy losses, premature labour, placental retention, foetal growth retardation and foetal malpresentations. The aetiology of MDAs is complex and heterogeneous, displaying a range of clinical pictures that generally lack a direct genotype-phenotype correlation. De novo and familial cases sharing the same genomic lesions have been reported. The familial cases follow an autosomal-dominant inheritance, with reduced penetrance and variable expressivity. Furthermore, few genetic factors and molecular pathways underpinning Müllerian development and dysregulations causing MDAs have been identified. The current knowledge in this field predominantly derives from loss-of-function experiments in mouse and chicken models, as well as from human genetic association studies using traditional approaches, such as microarrays and Sanger sequencing, limiting the discovery of causal factors to few genetic entities from the coding genome. In this Review, we summarise the current state of the field, discuss limitations in the number of studies and patient samples that have stalled progress, and review how the development of new technologies provides a unique opportunity to overcome these limitations. Furthermore, we discuss how these new technologies can improve functional validation of potential causative alterations in MDAs.

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