Malformations of the Uterus
There are six different uterine malformations that I will be discussing in this hub. These malformations are birth defects of the uterus that can cause a woman to have many miscarriages or difficulties during pregnancy. All women that have a malformation of the uterus should have an X-ray of the kidneys, as there can be a direct association between the malformation and the kidneys,
The arcuate uterus has a depression at the fundus. A woman with an arcuate uterus can carry a baby to full term pregnancy. However, this condition is associated with a higher risk for miscarriage and premature births. The best way for a woman to find if she has this malformation is through transvaginal ultrasonography, hysterosalpingography, MRI, or hysteroscopy. In most cases, the woman will not have any reproductive problems. For those that do have reproductive tribulations, there is the option to have a hysteroscopic resection performed.
The bicornuate (heart-shaped) uterus has a marked indentation and is separated into two different cavities. This malformation is a result from the uterus forming improperly in the woman’s early prenatal development. The way that a woman can confirm that she has a bicornuate uterus is by having an ultrasound or by the use of laparoscopy. The primary risk with having a bicornuate uterus is preterm labor and cervical insufficiency. The cervical insufficiency could cause the woman to have a miscarriage during the second trimester of pregnancy. The good news is that there is a chance that the baby can still survive. Furthermore, in some cases, a woman with this type of uterine malformation can carry the baby to full term with no complications. It just varies from person to person.
A woman with a didelphic uterus has a duplication of the uterus and a duplication of the cervix. In this malformation, there are two uterine cavities and two cervixes accompanying each cavity. It is not recommended that a woman have surgery to connect the two uteruses together. Women with this malformation may be asymptomatic. The malformation is normally found with a pelvic examination. There are two common complaints of women that have a didelphic uterus. There are complaints of dysmenorrheal (uterine pain during menstruation) and complaints of dyspareunia (painful sexual intercourse).
For a woman with this malformation of the uterus, special attention will be necessary during pregnancy. Premature births and malpresentation are common with this deformity.
Twins are also commonly associated with a didelphic uterine pregnancy. Although in most cases the pregnancy is preterm, the woman can normally carry the babies until the second trimester. There is a good chance that the infants can survive. However, there is a good possibility that the births can occur at separate times. Therefore, the labor and delivery of the multiple births can take days or weeks.
If a woman has a Unicornuate uterus, she will have a single uterine cavity with a cervix and one fallopian tube coming off of the uterus. In this malformation, the uterus only forms half-way. The other side of the uterus may have a rudimentary horn. An ultrasound can be used to find a Unicornuate uterine malformation. Further diagnostic test used to confirm this diagnosis are; hysteroscopy, ultrasound, and laparoscopy.
Unfortunately, a woman with this malformation can have much risk if she becomes pregnant. There is a great risk of pregnancy loss and preterm labor. Also, there is a chance of the woman having an ectopic pregnancy. The common miscarriages due to this malformation are caused by abnormalities in the blood supply of the uterus. The reason that there is a great risk for preterm labor is due to space restrictions in the Unicornuate uterus. Furthermore, for the woman with the rudimentary horn, she will have greater risks associated with pregnancy. This horn will cause a lot of space restriction which could result in ectopic pregnancy. This is the reason that most doctors recommend surgery to remove the rudimentary horn.
A woman with a septate uterine malformation will have the problem from which the septum separates the uterine cavity into two separate cavities. The septum will arise at the top of the uterine cavity and then extend down to the cervix and the vagina. It is normally recommended that a woman with this malformation have a simple outpatient surgical removal of the septum.
There is a risk of miscarriage associated with a septate uterine malformation. Furthermore, there is a chance of preterm labor. Doctors can normally find a septate uterine malformation with the use of an ultrasound. However, to confirm the diagnosis, the woman will need to have a hysteroscopy performed.
The absent uterus is the most severe of the uterine malformations. This malformation is also known as uterine agenesis. For a woman with this malformation, there is a failure for the uterus, cervix and vagina to develop. A girl with this malformation will experience puberty, with the absence of periods. The woman will only have a small dimple in the place where the vagina should be at. The external view of the genitals will look normal. However, with a closer examination, the discovery of a shallow vagina will be made. There is also a chance that there will be abnormalities of the kidneys and or bones with this malformation. An MRI will be needed to confirm this diagnosis.
The woman with this malformation can have sexual intercourse after having a surgical procedure to extend the length of the vagina. If a woman with an absent uterus wants to have children she can only do so through in vitro fertilization. This is possible because she will have eggs to use that can be combined with her partner’s sperm through a surrogate mother.
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