MULLERIAN ANOMALIES= 1=aplasia-aplasia may invovle d whole or part of d genital tract in female..a)ovary-ovarian agenesis appearing as a streak gonad is wel known..in turner's syndrome d streak ovary consits of undifferentiated stroma n devoid of germ cells..b) fallopian tube-hypoplasi is represented by a rudimetary tube wid an abdominal ostium n rudimentary fimbrae..c)uterus-unilateral development of d mullerian duct giving rise to d unicornuate uterus is known to occur..d)-vagina-failur of vagina to canalize may b partial or complete..depression marks d site of d hymen..vaginal aplasia associated wid absence of d uterus is encountered in testicular feminizing syndrome n rokitansky-kuster-hauser(RKH) syndrome..2=hypoplasia- more common than aplasia..manifestations include rudimentary horn, a pubescent or infantile small uterus or an infantile cervix..3=atresia-it invovle a part or whole tract..fallopian tube atresia may b partial or complete n leads to infertility..partial atresia of d cervix n uterus may lead to haematometra..4=haematocolpos-it is observed in young girls..girls present wid colicky abdominal pain wich is often cyclic..MULLERIAN DUCT ANOMALIES= mullerian duct anomalies result 4m defective fusion, canalization or absorption of d median septum of d female reproductive system during embryonic development...1) whn 2 mullerian ducts fail to fuse along d whole of their lengths, at develop normally n remain separate, a condition termed uterus didelphys results..in this two vaginas open at d vulva, cervix lies at d top of each vagina n d two parts of d uterus abovd d level of d cervices are completely separate..2) in uterus bicornis d vagina is single, bt d two cornua of d uterus remain separate n two complete cervices project into d vagina..3)in uterus bicornis unicolis d two cornua of d uterus are separate in d region of body bt thr is single cervix n a single vagina..4)in uterus septus, two mullerian ducts are fused a median septum passes 4m d fundus of d uterus through d cervix n may extend into d vagina..5)in uterus subseptus this sepptum is restricted to d body of d uterus..6)arcuate uterus- in this, thr is no actual septum in d region of fundus bt instead of d usual dome shaped convexity of d fundus, thr is a shallow concave depression..7)uncornuate uterus is seen in 1% cases n associated wid abnormality of kidney of tht side..
CLASSIFICATION=.1=Class1-segmental mullerian agenesis or hypoplasia..a-vaginal, b-cervical, c-fundal, d-tubal, e-combined..2=class2-unicornuate uterus..a-with rudimentary horn-1-with a communicating endmetrial cavity.2-with a non-communicating cavity..3-with no cavity..b-without any rudimentary horn..3=class3-uterus didelphys..4=class4-bicornuate uterus..a-complete up to d internal os..b-partial..c-arcuate..5=class5-septate uterus..a-with a complete septum..b-with an incomplete septum or uterus subseptus..6=class6-uterus with internal luminal changes.
.CLINICAL ASPECTS= clincal manifestations develop after> MULLERIAN DUCT ANOMALIES> clincal aspects> pubertal age n affect menstural, sexual,n reproductive fuctions..following obstetrical n gynaecological problems are due to partial fusion resulting in bicornuate n septate uterus..1-habtial abortions,2-preterm labour,3-persistent malpresentations like transverse lie,oblique lie,breech presentation..4-retained adherent placenta...INVESTIGETIONS=1-ultsasound of d pelvis n renal region for kidney abnormality..2-hysterogram 3-hysteroscope.4-laproscopy.5-chromosomal study.6-ct n mri..MANAGEMENT= 1=strassman utriculoplasty operation with a transverse fundal incision for reunification of the uterine cavity improves d obstetric outcome in women with bicornuate uterus..2=jones' operation of wedge rdsection of a part of d fundus, along wid d septum followed by uniting d two horns vertically,in women wid septate uterus n previous pregnancy loss..3=tomkins operationt for a septate uterus consists of incising d fundus in d midline,exposing d septum n excising it followed by reuniting d two parts in d midline..4=hysteroscopic resection of d septum with help of a resectoscope, or CO2 laser has simplified d procedure..
CLASSIFICATION=.1=Class1-segmental mullerian agenesis or hypoplasia..a-vaginal, b-cervical, c-fundal, d-tubal, e-combined..2=class2-unicornuate uterus..a-with rudimentary horn-1-with a communicating endmetrial cavity.2-with a non-communicating cavity..3-with no cavity..b-without any rudimentary horn..3=class3-uterus didelphys..4=class4-bicornuate uterus..a-complete up to d internal os..b-partial..c-arcuate..5=class5-septate uterus..a-with a complete septum..b-with an incomplete septum or uterus subseptus..6=class6-uterus with internal luminal changes.
.CLINICAL ASPECTS= clincal manifestations develop after> MULLERIAN DUCT ANOMALIES> clincal aspects> pubertal age n affect menstural, sexual,n reproductive fuctions..following obstetrical n gynaecological problems are due to partial fusion resulting in bicornuate n septate uterus..1-habtial abortions,2-preterm labour,3-persistent malpresentations like transverse lie,oblique lie,breech presentation..4-retained adherent placenta...INVESTIGETIONS=1-ultsasound of d pelvis n renal region for kidney abnormality..2-hysterogram 3-hysteroscope.4-laproscopy.5-chromosomal study.6-ct n mri..MANAGEMENT= 1=strassman utriculoplasty operation with a transverse fundal incision for reunification of the uterine cavity improves d obstetric outcome in women with bicornuate uterus..2=jones' operation of wedge rdsection of a part of d fundus, along wid d septum followed by uniting d two horns vertically,in women wid septate uterus n previous pregnancy loss..3=tomkins operationt for a septate uterus consists of incising d fundus in d midline,exposing d septum n excising it followed by reuniting d two parts in d midline..4=hysteroscopic resection of d septum with help of a resectoscope, or CO2 laser has simplified d procedure..
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