Congenital structural abnormalities Flashcards
(19 cards)
What causes congenital structural abnormalities?
Caused by abnormal development of the pelvic organs prior to birth which can lead to menstrual, sexual and reproductive problems. May be a result of faulty genes, or occur randomly in otherwise healthy individuals.
What does the upper vagina, cervix, uterus & fallopian tubes develop from?
Paramesonephric ducts - Mullerian ducts. Errors in their development lead to congenital structural abnormalities in the female pelvic organs.
Why do men not get female parts?
Anti-Mullerian hormone is produced, which suppresses the growth of the paramesonephric ducts, causing them to disappear.
What is a bicornuate uterus?
Where there are two ‘horns’ to the uterus, giving it a heart-shaped appearance. It can be diagnosed on a pelvic USS.
What are typical complications of bicornuate uterus?
- Miscarriage
- Premature birth
- Malpresentation.
What is an imperforate hymen?
Where the hymen at the entrance of the vagina is fully formed, without an opening.
When are imperforate hymens usually discovered?
When the girl starts to menstruate and the menses are sealed in the vagina, causing cyclical pelvic pain and cramping that would usually be associated with menstruation without any vaginal bleeding.
What is the treatment of the imperforate hymen?
Surgical incision to create an opening in the hymen.
What happens if imperforate hymen is not treated?
Retrograde menstruation → endometriosis.
What is transverse vaginal septae?
Caused by an error in development where a septum forms transversely across the vagina. The septum can either be perforate or imperforate.
How does a perforate septum present?
Girls will still menstruate but can have difficulty with intercourse or tampon use.
How can imperforate septum present?
Presents similar to imperforate hymen with cyclical pelvic symptoms without menstruation.
What can transverse vaginal septae lead to?
Infertility and pregnancy related complications.
How is diagnosis of transverse vaginal septae made?
Examination, USS or MRI.
What is treatment of transverse vaginal septae?
Surgical correction.
What are the main complications of vaginal septae surgery?
Vaginal stenosis and recurrence of septae.
What is vaginal hypoplasia?
Refers to an abnormally small vagina.
What is vaginal agenesis?
Refers to an absent vagina which occurs due to failure of the Mullerian ducts to properly develop and may be associated with an absent uterus and cervix.
Management of vaginal hypoplasia/agenesis?
Use of a vaginal dilator over a prolonged period to create an adequate vaginal size. Vaginal surgery may be necessary.
