Uterine anomalies are often associated with vaginal maldevelopment.
Incidence of Mullerian abnormalities: It varies between 3 and 4%. The incidence is found to be high in women suffering from recurrent miscarriage or preterm deliveries (5–20%).
- Failure of development of one or both Mullerian ducts The absence of both ducts leads to absence of uterus, including oviducts. There is absence of vagina as well.
Primary amenorrhea is the chief complaint. The absence of one duct leads to a unicornuate uterus with a single oviduct.
- Failure of recanalization of the Mullerian ducts Agenesis of the upper vagina or of the cervix—This may lead to hematometra as the uterus is functioning.
Failure of fusion of Mullerian ducts: - In majority, the presence of deformity escapes attention. In some, the detection is made accidentally during investigation of infertility or repeated pregnancy wastage. In others, the diagnosis is made during D E operation, manual removal of placenta or during cesarean section.
- Arcuate (18%): The cornual parts of the uterus remains separated. The uterine fundus looks concave with heart-shaped cavity outline.
- Uterus didelphys (8%): There is complete lack of fusion of the Mullerian ducts with a double uterus, double cervix and a double vagina.
- Uterus bicornis (26%): There is varying degrees of fusion of the muscle walls of the two ducts.
− Uterus bicornis bicollis: There are two uterine cavities with double cervix with or without vaginal septum.
− Uterus bicornis unicollis: There are two uterine cavities with one cervix. The horns may be equal or one horn may be rudimentary and have no communication with the developed horn.
- Septate uterus (35%): The two Mullerian ducts are fused together but there is persistence of septum in between the two either partially (sub septate) or completely.
- Uterus unicornis (10%): Failure of development of one Mullerian duct.
The medicines that can be thought of use are:-
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