Normal & Abnormal Genital Tract Development PDF

Abnormal development Of the female genital System Melad Alias  OBSTRUCTIVE MULLERIAN ANOMILY Transverse vaginal septum Cervical agenesis Imperforated hymen Patients usually presents with cyclical abdominal pain or amenorrhea due to accumulation o...

Abnormal development Of the female genital System Melad Alias  OBSTRUCTIVE MULLERIAN ANOMILY Transverse vaginal septum Cervical agenesis Imperforated hymen Patients usually presents with cyclical abdominal pain or amenorrhea due to accumulation of menstrual blood.  HYMAN 1–2 centimeters of the vaginal opening (introitus) creating a partial boundary between the external and internal genital organs.  Diagnosis HISTORY EXAMINATION U/S MRI  In infants/ Adolescents Infants , the obstructed vagina is distend from mucus accumulation ( Hydro-muco- colpos ) Adolescents menstrual blood trapped in the vagina behind the imperforated hymen ( Hemato-calpos ) Transverse vaginal septum Sinovaginal bulb & uterovaginal Canal Bluish bulge at the introitus Hemato-metra hemato-salpinx Cyclic pain Amenorrhea Abdominal pain Difficulty in urination or defecation  Treatment Hymenotomy Eleptical or cruciate incision drainage Laparascopy to confirm endometriosis  Fusion anomalies Incidence → up to 6% Are associated with renal anomalies 30% Associated complications : Recurrent pregnancy loss ….. Infertility Obstetrical outcome……. Pain & dysmenorrhea…… vaginal masses ….. Dyspareunia ……. Menstrual abnormalities  Longitudinal vaginal septum Unicornuate uterus  Uterus didelphys  Uterine Didelphys 2 uteri , 2 endometrial cavities , 2 cervices It is due to failed fusion of Mullerian ducts. It has the best reproductive prognosis but there is chance of late trimester losses or preterm deliveries.  Bicornuate uterus Incomplete lateral fusion of the mϋllerian ducts Biconuate unicollus have one cervix 2 separate but communicating endometrial cavities Septate & sub-septate uterue  Septate & sub-septate uterue After lateral fusion of the mullerian ducts , failure of their medial segments to regress Septum may be partial or completely extends to the cervix It could be fibrous to fibromuscular. Riskmiscarriage, premature labor or breech presentation  Mayer Rokitansky kuster Hauser syndrome Primary amenorrhea Normal secondary sexual characters Normal external genitalia Absent uterus, cervix, upper vagina Normal ovaries Surrogacy Associated congenital renal 15% Skeletal anomalies 12%  Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare disorder that affects women. It is characterized by the failure of the uterus and the vagina to develop properly in women who have normal ovarian function and normal external genitalia.  SEGMENTAL MÜLLERIAN HYOPLASIA OR AGENESIS Vaginal agenesis : lack the lower portion of the vagina but otherwise have normal external genitalia