DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160406

Septate uterus with cervical duplication and a longitudinal vaginal septum: an unclassified mullerian anomaly

Ruchika Mangla, Tajinder Kaur, Nayana Pathak

Abstract


Uterine anomalies are the result of disturbances in the development, formation or fusion of the mullerian ducts during foetal life with an incidence of 0.001%-10% in general population. These patients most often present with amenorrhoea, dysmenorrhoea, dyspareunia and infertility. Women with these anomalies are more prone to poor foetal outcomes such as first trimester losses or preterm labour. We report a case of a 35 years old female with septate uterus with cervical duplication and a longitudinal vaginal septum. Diagnosis was obtained by physical examination, ultrasound imaging, hysterosalphingography and magnetic resonance imaging and hysterolaproscopy. The clinical presentation of such a case & surgical options available were studied, and the excision of the vaginal septum was done. This case of congenital uterine anomaly does not fit into the current classification system of mullerian anomalies by American fertility society, which is based on the traditional caudal to cranial, unidirectional developmental pattern. This strongly indicates the possibility of an alternative mechanism of mullerian development.

Keywords


Septate uterus, Cervical duplication, Longitudinal vaginal septum

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References


Green LK, Harris RE. Uterine anomalies: frequency of diagnosis and associated obstetric complications. Obstet Gynecol. 1976;47:427-9.

Chang AS, Siegel CL, Moley KH, Ratts VS, Odem RR. Septate uterus with cervical duplication and longitudinal vaginal septum: a case report of five new cases. American Soc Reprod Med. 2004;81(4):1133-6.

Duffy D, Nulsen J, Maier D, Schmidt D, Benadiva C. Septate uterus with cervical duplication: a full-term delivery after resection of a vaginal septum. Fertil Steril. 2004;81:1125-6.

Dunn R, Hantes J. Double cervix and vagina with a normal uterus and blind cervical pouch: a rare mullerian anomaly. Fertil Steril. 2004;82:458-9.

Lin PC, Kunwar PB, Nettleton GS, Nakajima ST. Female genital anomalies affecting reproduction. Fert Steril. 2002;78:899-915.

Acien P. Incidence of mullerian defects in fertile and infertile women. Hum Reprod. 1997;12:1372-6.

Wai C, Zekam N, Sanz L. Septate uterus with double cervix and longitudinal vaginal septum. J Reprod Med. 2001;46:613-7.

Acien P. Reproductive performance of women with uterine malformations. Hum Reprod. 1993;8:122-6.

Muller P, Musset R, Netter A, Solal R, Vincourd JC, Gillet JY. Etat du haut apparel urinaire chez le porteuses de malformations uterines. Etude de observations. Presse Med. 1967;75:133-6.

Pavone ME, King JA, Vlahos N. Septate uterus with cervical duplication and a longitudinal vaginal septum: a mullerian anomaly without a classification. American Soc Reprod Med. 2006;85(2);494.

American Fertility Society. Classification of mullerian anomalies. Fertil Steril. 1988;49:944-55.