Analysis of Mullerian developmental defects in a tertiary care hospital: a four year experience

Authors

  • Swati N. Patel Department of Obstetrics & Gynaecology, GMERS Medical College, Sola, Ahmedabad-380060, Gujarat, India
  • Ajesh N. Desai Department of Obstetrics & Gynaecology, GMERS Medical College, Sola, Ahmedabad-380060, Gujarat, India
  • Dirgha H. Pamnani Department of Obstetrics & Gynaecology, GMERS Medical College, Sola, Ahmedabad-380060, Gujarat, India
  • Komal P. Modi Department of Obstetrics & Gynaecology, GMERS Medical College, Sola, Ahmedabad-380060, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20150053

Keywords:

Mullerian anomalies, TVS, Unicornuate uterus, Bicornuate uterus

Abstract

Background: Mullerian duct anomalies are congenital anomalies of the female genital tract. Mullerian duct anomalies affect the reproductive health of the female to a varied extent. This may present as obstructive or as non-obstructive anomalies. When clinically suspected, proper investigations are required to confirm the diagnosis including ultrasonography, laparoscopy and hysteroscopy.

Methods: In the present study, all the patients presenting with Mullerian duct anomalies to the gynaecology OPD at General Hospital, Sola, GMERS Medical College, Ahmedabad during the four year duration from 2011 to 2014 were included. These patients were analysed with respect to their incidence, presenting complain, age at presentation, classified according to AFS classification after proper diagnosis and managed individually.

Results: The incidence of Mullerian duct anomalies was found to be 0.084%.52.9% belonged to the age group of 21 to 25 years. Most of these patients (73.5%) presented with chronic complains. Only a few presented with acute symptoms (14.7%) whereas a few were asymptomatic (11.8%). Septate uterus (20.6%) was the most common anomaly diagnosed at our setup followed by bicornuate uterus (17.7%) and tansverse vaginal septum (17.6%). History along with clinical and USG examination were adequate in diagnosis of patients with vaginal agenesis, didelphic, bicornuate uterus, TVS and imperforate hymen. Laparoscopy was needed to confirm cases of MRKH & unicornuate uterus and hysteroscopy for cases of septate uterus. Arcuate uterus was diagnosed during LSCS.

Conclusions: It was thus concluded that with timely evaluation, diagnosis and optimal management, their menstrual disturbances are relieved early in adolescence period recuperating their psychiatric health & improving their reproductive carrier. Delay in management may cause serious complications and potential infertility.

References

John A. Rock, Lesley L. Breech. Surgery for anomalies of Mullerian ducts. In: Rock JA, Jones HW, eds. Te Linde’s Operative Gynaecology. 10th ed. Philadelphia: Lippincott Williams Wilkins; 2013: 539-584.

Rackow BW, Arici A. Reproductive performance of women with Mullerian anomalies. Curr Opin Obstet Gynaecol. 2007;19:229-37.

John A. Rock, Lesley L. Breech. Surgery for anomalies of Mullerian ducts. In: Rock JA, Jones HW, eds. Te Linde’s Operative Gynaecology. 10th ed. Philadelphia: Lippincott Williams Wilkins; 2013: 539-584.

Evans TN, Poland ML, Boving RL. Vaginal malformations. Am J Obstet Gynaecol. 1981;141:910-20.

Jayati Nath, Nayana Pathak. A study of Mullerian anomalies in a tertiary care teaching hospital of North India. Int J Sci Res. 2015;4:1020-2.

Crook DO, John B, Gebbert MD. Congenital anomalies of the female urogenital tract. J Pelvic Med Surg. 2005;11:165-81.

Strassmann EO. Operations for double uterus and endometrial atresia. Clin Obstet Gynecol. 1961;4:240.

Strassmann EO. Fertility and unification of double uterus. Fertil Steril. 1966 Mar-Apr;17(2):165-76.

Golan A, Langer R, Bukovsky I, Caspi E. Congenital anomalies of Mullerian system. Fertil Steril. 1989 May;51(5):747-55.

Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001;7:161-74.

Mane SB, Shastri. Our 10-year experience of variable Mullerian anomalies and its management. Pediatr Surg Int. 2010;26:795-800.

Reindollar RH, Byrd JR, McDonough PG. Delayed sexual development: a study of 252 patients. Am J Obstet Gynaecol. 1981;140:371-80.

Banerjee I, Mondal SC, Dam P, Roy P. Case series of Mullerian developmental defects encountered in a tertiary care hospital: a one-year experience. Open J Obstet Gynecol. 2014;4:733-44.

Jeon GH, Park YR, Shin YJ. Clinical characteristics of women with Mullerian anomaly: twenty years of experience at Asan medical center. Korean J Obstet Gynaecol. 2010;53:626-32.

Parikh RM, Nakum K, Kadikar GK, Gokhle AV. Mullerian anomalies: a cause of primary amenorrhea. Int J Reprod Contracept Obstet Gynecol. 2013;2:393-7.

Ayush Goel, Frank Gaillard. Mullerian duct anomaly classification. Available at: http://radiopedia.org/articles/mullerian –duct-anomaly-classification.

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Published

2017-02-08

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Original Research Articles