The Unicornuate Uterus and Its Variants

Khati, Nadia J.; Frazier, Aletta Ann; Brindle, Kathleen A.

doi:10.7863/jum.2012.31.2.319

Cited by 69 publications

(34 citation statements)

References 11 publications

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“…Mullerian anomalies consist of hypoplasia/agenesis (1.2% vs. 0.0%), arcuate (16.5% vs. 2.1%), septate (4.6% vs. 0.5%), bicornuate (6.1% vs. 0.7%) [Figure 5], unicornuate (0.9% vs. 0.4%) [Figure 6], and didelphus (0.2% vs. 0.2%) uterus without and with intravasation during HSG, respectively were detected according to the American Fertility Society (AFS) classification. [242526] No statistically significant difference was detected between the control and intravasation groups regarding the tubal patency due to increased pressure ( P = 0.172).…”

Section: Resultsmentioning

confidence: 95%

“…[24] Moreover, Mullerian anomalies prevalence was reported as 5-10% and 25% in patients with recurrent first- and second-trimester abortus, respectively. [26] The higher incidence of abortus risk among patients with Mullerian anomalies was demonstrated as well. [24] Although intravasation can occur in patients during HSG, there are some predisposing factors such as uterine anomalies.…”

Section: Discussionmentioning

confidence: 99%

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Venous Intravasation as a Complication and Potential Pitfall During Hysterosalpingography: Re-Emerging Study with a Novel Classification

Duşak

Soydinç

Önder

et al. 2013

Journal of Clinical Imaging Science

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Objectives:Presently, hysterosalpingography (HSG) is used as a means to evaluate women with infertility and repetitive pregnancy loss. Venous intravasation is a complication and potential pitfall during HSG and analogous procedures including hysteroscopy. The aim of our study was to assess the venous intravasation and to obtain critical information for more secure and more accurate procedures. In particular, the primary goal of the present study was to compare HSG without and with intravasation to identify differences seen on HSG and to assess the predisposing factors of intravasation. The secondary goal was to describe clinical- and imaging-based novel classification of intravasation.Materials and Methods:This study included a patient cohort of 569 patients who underwent HSG between 2008 and 2011 at our center in the absence (control group) or presence (study group) of intravasation. Intravasation classified from level 0 (no intravasation) to level 3 (severe intravasation) was compared with preprocedural (demographic and clinical) and procedural (HSG) data. Data were analyzed using Statistical Package for Social Sciences (SPSS) statistical software.Results:Of the 569 patients undergoing HSG, 528 showed no intravasation and 41 (7.2%) patients showed intravasation when associated with preprocedural (leukocytes, menometrorrhagia, secondary infertility, ectopic pregnancy, abortus, polycystic ovaries, endometriosis, and interventions) and procedural (pain, scheduling, endometrial-uterine nature, and spillage) parameters. Moreover, intravasation was lower in women with smooth endometrium, triangular uterus, and homogeneous peritoneal spillage. No association was found between age, tubal patency, increased pressure, and intravasation.Conclusions:Using a novel classification method, intravasation can be observed in women during HSG and associates with preprocedural and procedural predisposing factors in subsumed conditions. This classification method will be useful for improving the efficiency and accuracy of HSG and related procedures by minimization of severe complications caused by intravasation.

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Section: Resultsmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Venous Intravasation as a Complication and Potential Pitfall During Hysterosalpingography: Re-Emerging Study with a Novel Classification

Duşak

Soydinç

Önder

et al. 2013

Journal of Clinical Imaging Science

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“…Patients who have a unicornuate uterus with rudimentary horn have an increased incidence of gynecologic problems and tend to present, at menarche or later in their life, symptoms such as dysmenorrhea and chronic pelvic pain [10]. …”

Section: Discussionmentioning

confidence: 99%

Pregnancy in a unicornuate uterus: a case report

Caserta¹,

Mallozzi²,

Meldolesi

et al. 2014

J Med Case Reports

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IntroductionA unicornuate uterus accounts for 2.4 to 13% of all Müllerian anomalies. A unicornuate uterus with a non-communicating rudimentary horn may be associated with gynecological and obstetric complications such as infertility, endometriosis, hematometra, urinary tract anomalies, abortions, and preterm deliveries. It has a poor reproductive outcome and pregnancy management is still unclear.Case presentationWe report a case of a 26-year-old Caucasian woman presenting with a unicornuate uterus with a non-communicating rudimentary horn. The diagnosis of the anomaly was based on two-dimensional and three-dimensional sonography. The excision of her symptomatic rudimentary horn and her ipsilateral fallopian tube was performed laparoscopically. The growth of the fetus was normal. At 20 weeks’ pregnancy, her cervix started shortening and a tocolytic therapy was started. A cesarean delivery was successfully performed at 39 weeks and 4 days’ gestation.ConclusionsAlthough the reproductive outcome of women with unicornuate uterus is poor, a successful pregnancy is possible. Routine excision of the rudimentary horn should be undertaken during non-pregnant state laparoscopically, and it would be necessary to screen such pregnancies for the development of intrauterine growth retardation with serial ultrasound assessments of the estimated fetal weight and the cervix length.

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“…HSG can be done to differentiate the two, but MRI is the preferred non-invasive modality. Both of them show cavitated mass lined by endometrium with hemorrhagic contents within it, but contralateral tilt of the uterus, banana-shaped small uterine cavity, and a single cornua favors obstructed horn[13] over ACUM which was not seen in our case. However, at times, the differentiation may not be possible on MRI and laparoscopy remains the only option available for confirmation and treatment.…”

Section: Discussionmentioning

confidence: 60%

Imaging diagnosis of accessory and cavitated uterine mass, a rare mullerian anomaly

Jain

Verma

2014

Indian Journal of Radiology and Imaging

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Accessory and Cavitated Uterine Mass (ACUM) is a rare form of developmental Mullerian anomaly seen in young females, which presents as chronic recurrent pelvic pain and severe dysmenorrhea. It is an accessory cavity lying within an otherwise normal uterus. It is lined by functional endometrium and surrounded by myometrium-like smooth muscle cells; hence, it bears striking macroscopic and microscopic resemblance to the uterus. Hysterosalpingography (HSG), Ultrasonography (USG), and Magnetic Resonance Imaging (MRI) form the mainstay of diagnostic imaging. The entity is often under diagnosed; therefore, a high index of suspicion combined with HSG and MRI imaging can help in making an accurate diagnosis.

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The Unicornuate Uterus and Its Variants

Cited by 69 publications

References 11 publications

Venous Intravasation as a Complication and Potential Pitfall During Hysterosalpingography: Re-Emerging Study with a Novel Classification

Venous Intravasation as a Complication and Potential Pitfall During Hysterosalpingography: Re-Emerging Study with a Novel Classification

Pregnancy in a unicornuate uterus: a case report

Imaging diagnosis of accessory and cavitated uterine mass, a rare mullerian anomaly

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