Uterus didelphys

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[edit] Discussion

  • Uterus didelphys constitutes approximately 5% of müllerian duct anomalies.
  • Result of nearly complete failure of fusion of the müllerian ducts. Each müllerian duct develops its own hemiuterus and cervix and demonstrates normal zonal anatomy with a minor degree of fusion at the level of the cervices. No communication is present between the duplicated endometrial cavities.
  • A longitudinal vaginal septum is associated in 75% of these anomalies.

  • Spontaneous abortion rates are reported to range from 32% to 52% (pooled data, 45%).
  • Premature birth rates range from 20% to 45% (pooled data, 38%).

[edit] Imaging Findings

[edit] HSG

  • HSG demonstrates two separate endocervical canals that open into separate fusiform endometrial cavities, with no communication between the two horns.
  • Each endometrial cavity ends in a solitary fallopian tube.
  • If the anomaly is associated with an obstructed longitudinal vaginal septum, only one cervical os may be depicted, and it may be cannulated with the endometrial configuration mimicking a unicornuate uterus.

[edit] US

  • Separate divergent uterine horns are identified with a large fundal cleft.
  • Endometrial cavities are uniformly separate, with no evidence of communication.
  • Two separate cervices need to be documented.

[edit] MR

  • MR imaging demonstrates two separate uteri with widely divergent apices, two separate cervices, and usually an upper vaginal longitudinal septum.
  • In each uterus, normal uterine zonal anatomy is preserved.

[edit] Images

Patient #1: Uterus didelphys with a leiomyoma in the right horn

[edit] See Also

[edit] External Links

Goldminer: Didelphys

[edit] References