congenital anomalies of uterus briefly more towards anatomy, not aproach

1. Anomalies Of Uterus
Nur Amalina bt. Aminuddin Baki
082012100067

2. Objective
• The student should be able to :
Identify the classification of uterus anomalies
based on their causes
List the anomalies of uterus under each
classification

3. Introduction
• Anomalies of uterus can be classified based on
their cause:
absent or incomplete migration of the
paramesonephric duct
partial or complete failure of the lower parts of
the two paramesonephric ducts (Müller) to fuse
 failure of resorption of the median dividing wall
of the two paramesonephric ducts
• Cervix = Collis (hill) , Uterus=Cornis (horn)

4. Genes involved
Gene WNT4
• Ovary Determining Gene
• upregulates DAX1 (nuclear hormone receptor
family) that inhibit SOX9
• Regulate expression other genes responsible for
for ovarian differentiation
TAFII105 gene - a subunit for TATA- binding
protein for RNA polymerase in ovarian follicular
cells.

5. Development of Uterus and Vagina
• Second part of Paramesonephric ducts fuse in
midline,then canalize to form uterus.
• When paramesonephric duct reaches
urogenital sinus,two evaginations (sinovaginal
bulbs) grow out, proliferate and form vaginal
plate.
• Vaginal outgrowth entirely canalized by 5th
month.

6. Absent or Incomplete Migration of
the Paramesonephric Duct
• an atresia (Absence or abnormal narrowing of
opening ) and/or complete or incomplete
aplasia(failure to develop or function) of the
uterus.
• Example:
• Unicornuate uterus (complete aplasia)
– One half of uterus is absent

7. •Atresia of cervix
Atresia of both
muller tube
•Atresia of vagina
Sinovaginal bulbs fail
to fuse

8. •mayer-rokitansky-küster-hauser
syndrome
Uterus and upper vagina absent

9. Failure of the Lower Parts of Müller
to Fuse
• Uterus didelphys( G:delphys = womb)
– Double uterus, double cervix and double vagina
• Uterus bicornis bicollis
– Double uterus, double cervix, one vagina
• Uterus bicornus unicollis
– Double uterus, one cervix, one vagina
• Uterus arcuatus
– Uterus slightly endented

11. Failure of Resorption of the Median
Dividing Wall
• The leads to a septated uterus:
• Uterus septus
from the body to the uterine cervix
• Uterus subseptus subtotalis unicollis
only in the body region
• Uterus subseptus unicornis bicollis
only in the cervical region

12. Uterus septus
Uterus
subseptus
subtotalis
unicollis
Uterus
subseptus
unicornis
bicollis

13. Conclusion
• Defect of migratory
– Unicornuate uterus, atresia of cervix and vagina
• Defect of fusion
– Uterus didelphys, uterus bicornis bicollis , uterus
bicornus unicollis and uterus arcuatus
• Defect of resorption
– Uterus subseptus subtotalis ,Uterus subseptus
subtotalis unicollis and Uterus subseptus unicornis
bicollis

14. Reference
• Inderbir Singh and GP Pal, Human
Embryology, 8th
edition, Macmillan India
Limited, 2007,page 251.
• T.W. Sandler, Langman’s Human Embryology,
11th
Edition,Wolters Kluwer,2007, page 254.