Congenital uterine malformations are deviations from normal anatomy resulting due to defective fusion of Mullerian ducts or the paramesonephric ducts in the developing embryo.
The prevalence of female genital tract anomalies is 4%-7% in general population and up to 8%-10% in women who have recurrent pregnancy loss.(1) The type and degree of anatomical distortion has associated health implications that may include, cyclical abdominal pain, reproductive failure, obstructed menses and inability to engage in sexual intercourse.(2)
Uterus didelphys (double uterus) is a developmental abnormality that results from the failure of fusion of the Mullerian ducts leading to separate uterine cavities and 2 cervices 1. It is a rare anomaly accounting for 5% of all uterine anomalies. (3) Cervical agenesis is a rare Mullerian anomaly with an incidence of 1 in 80,000 females. (4) It represents 3% of all uterine anomalies. It is rarely associated with a functioning uterus (4.8%). Cervical agenesis is often associated with vaginal atresia (less than 50%). It is important to classify these anomalies for easy diagnosis and plan appropriate preoperative treatment.
Case report, Cervical atresia, Mullerian anomaly, Uterine Didelphis.
2. B. Bhagavath GE, K.M. Griffiths, T. Winter, S. Alur-Gupta, C. Richardson, S.R. Lindheim. Uterine malformations: an update of diagnosis, management, and outcomes. Obstetrical & Gynecological Survey 2017;377-392.
3. Gomathy E SSR, Lakshmi G. Uterus didelphys with unilateral vaginal obstruction having single pregnancy in her right horn. A case report. J Clin Biomed Sci 2013;3(3):143-45.
4. Divya Dwivedi MJ, Shuchi Jain , Shivi Jain. A rare case report on complete cervical agenesis with vaginal atresia and suspended didelphys uterus with hematometra and left haematosalpinx. Int J Reprod Contracept Obstet Gynecol. 2020;9(3)1274-1277.
5. Grigoris F Grimbizis 1 SG, Attilio Di Spiezio Sardo, Sara Brucker, Carlo De Angelis, Marco Gergolet, Tin-Chiu Li, Vasilios Tanos, Hans Brölmann, Luca Gianaroli, Rudi Campo. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Human Reproduction. 2013;Vol.28, No.8 pp. 2032-2044.
6. Society TAF. The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Mullerian anomalies and intrauterine adhesions FERTILITY AND STERILITY. June 1988 Vol. 49, No.6.
7. Carrington BM HH, Nuruddin RN, Secaf E, Laros RK, Hill EC. Müllerian duct anomalies: MR imaging evaluation. Radiol. 1990;176:715‑20.
8. Jay Spence M, Patricia Gervaize, PhD, and Shilpa Jain, MD. Uterovaginal Anomalies: Diagnosis and Current Management in Teens. Current Women’s Health Reports. 2003;3:445-450.
9. Rock JA, Carpenter, S. E., Wheeless, C. R., & Jones, H. W. The clinical management of maldevelopment of the uterine cervix. Journal of Pelvic Surgery. Sep 1995;1(3):129-33.