Congenital Gynecologic Defects and Mullerian Anomalies Flashcards
5 cardinal steps in mullerian development
1) elongation
2) fusion
3) canalization
4) septal resorption
5) union of mullerian system (cephalad) with urogenital sinus (caudad)
when does elongation begin?
6-7 weeks
when is fusion complete
14 weeks
what is the timeline of the union of the mullerian and sinovaginal bulb?
growth and fusion at 15-26 weeks
what originates from the sinovaginal bulb
the lower vagina and hymen
what causes class 1: mullerian agenesis/hypoplasia?
failed elongation
what causes class 2: unicornate uterus?
failed elongation
what causes class 3: uterine didelphys
failed fusion
50% will have a longitudinal vaginal septum
what causes a class 4: bicornuate uterus
failed fusion
what is significant about a bicornuate uterus
the cavity has decreased capacity so often have pre-term babies
what causes a class 5: septate uterus
failed septal resorption
what is significant about a septate uterus
the septum is avascular so if the pregnancy implants there it will undergo miscarriage
what is significant about an arcuate uterus
it is a normal variant with slightly larger fundus, but doesn’t cause any problems
what causes imperforate hymen
failure of the caudal end of the sinovaginal bulb to canalize
what causes transverse vaginal septum
failed canalization of the vaginal plate (where the mullerian ducts meet the urogenital sinus)
