Unicornuate or bicornuate uterus

Introduction One side of the middle kidney tube is well developed, forming a well-developed single-horned uterus with a normal developing fallopian tube. The development of the contralateral renal tube completely stopped. The function of the single-horned uterus may be normal. In pregnancy, pregnancy and childbirth can be normal, but may also cause miscarriage or dystocia.

Cause

The single-angle uterus has a well-developed mononeural uterus. The double-horned uterus has a large fusion at the end of the renal tube, and the bottom of the uterus is incomplete. The shape of the uterus is double-angled.

The causes of uterine dysplasia are multifaceted, and the basic research in this field is not deep enough. The study found that the bilateral renal tube in the process of evolution, affected by some factors and interference, can stop development at different stages of evolution to form a variety of abnormally developed uterus.

an examination

Related inspection

Hysterosalpingography, obstetrics, B-ultrasound

If the patient has a history of primary amenorrhea, dysmenorrhea, infertility, habitual abortion, fetal position in each pregnancy, or dystocia, the possibility of uterine malformation should be first considered, and the medical history and gynecological examination should be further detailed. If necessary, use a probe to detect the size and direction of the uterine cavity, or perform hysterosalpingography to confirm the diagnosis. Genital malformations often associated with urinary system malformations or lower gastrointestinal malformations, if necessary, can be used for intravenous pyelography or barium enema examination. When a urinary tract or lower gastrointestinal malformation is found, detailed examination of genital malformations, including uterine malformations, is also required.

Differential diagnosis

Differential diagnosis of single or double uterus:

1. Congenital absence of uterus: the bilateral renal tube on both sides extends to meet the midline and meets. If the development is stopped before the midline, no uterus is formed. Congenital absence of the uterus often combined with congenital absence of vagina, but can have normal fallopian tubes and ovaries. In the anus examination, it is equivalent to the cervix and uterus, and the uterus is not touched.

2, the beginning of the uterus: If the bilateral middle and middle kidney tubes extend to the midline and then stop growing shortly after the convergence, the uterus is very small, there is no uterine cavity or although there is no uterine cavity without endometrial growth, so there is no menstruation The tide.

3, naive uterus: at any stage of pregnancy or after the birth of the fetus to any time before puberty, the uterus stops developing, there may be various degrees of uterine hypoplasia. The cervix of this type of uterus is relatively long, mostly conical, and the outer mouth is small; the uterus is smaller than normal, often showing extreme flexion or flexion. Forequarters often have dysplasia of the anterior wall of the uterus, and those with posterior flexion often have hypoplasia of the posterior wall of the uterus A naive uterus can cause dysmenorrhea, less menstruation, amenorrhea or infertility.

4, residual uterus: one side of the middle kidney tube development is normal, the other side of the development process during the stagnation and other abnormal conditions, and the formation of varying degrees of residual uterus, most through the fiber bundle and the contralateral single-horned uterus Join. Because the inner membrane is mostly non-functional, it is often asymptomatic. If there is a function, symptoms of menstrual blood retention such as periodic lower abdominal pain appear after puberty. Some have a narrow cavity with the contralateral uterus. In this case, a residual uterine pregnancy can occur. The symptoms, such as tubal interstitial pregnancy, often rupture within 3 to 4 months of pregnancy, and severe internal bleeding occurs.

5, blind uterus: bilateral renal tube development is better, but one side of the uterine horn does not communicate with the vagina, forming a blind uterus. After menstruation, menstrual cramps, periodic lower abdominal pain, and increasingly serious, long-term not found. Blood retention, can cause uterine hemorrhage, fallopian tube blood, and even menstrual blood can flow into the abdominal cavity through the umbrella end of the fallopian tube. An enlarged mass can be reached in the lower abdomen. Some blind horns have a vagina that is not fully developed, but does not communicate with the normal vagina. After the vaginal blood is formed, it can be misdiagnosed as a vaginal cyst. Treatment: Through the orthopedic surgery, the blind uterus communicates with the contralateral uterine cavity or vaginal cavity.

6, double uterus and repeated uterus (symmetric type): these two abnormalities are very similar. The former is due to the absence of reunion after the development of the secondary renal tube, each with a set of fallopian tubes, uterus, cervix and vagina, this situation is relatively rare. The latter is also known as the double-horned double-necked double uterus, which is completely rendezvous in the sub-neural tube, but the septum is completely unabsorbed. The only difference between the two is that the gap between the two uterus is wider than the latter. The double uterus may or may not have a vaginal mediastinum.

7. Mediastinal uterus: After the bilateral renal tube meets, the mediastinum is not absorbed, and the palace is divided into two halves, but the shape of the uterus is completely normal. Sometimes the mediastinum is incomplete, resulting in a small passage between the two separate uterus-cervical, so it is said to communicate with the uterus. Often accompanied by vaginal mediastinum, the channel is often located in the uterine isthmus. Sometimes the vaginal part of one side is locked, and the retained menstrual blood can flow slowly through the isthmic passage to the contralateral side of the vagina, so the patient can see a doctor because of the frequent outflow of old bloody secretions from the vagina.

8, saddle-shaped uterus: the bottom of the palace depression, the degree can be different.

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