Document Detail

Non-obstructive müllerian anomalies.
MedLine Citation:
PMID:  25438707     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: The nonobstructive group of anatomic variants involving the reproductive tract includes vaginal agenesis as well as the congenital anomalies of the vagina and uterus, occurring without pain during the pubertal years.
OBJECTIVE: The objective is to discuss the non-obstructive morphologic variations in anatomy of the uterus and vagina.
DESIGN: Systematic review using the GRADE system.
RESULTS: These congenital anomalies are not associated with abnormalities of the external genitalia and therefore may be missed on routine physical examination. When these anomalies do cause symptoms they may be as minor as difficulty with menstrual hygiene or more significant such as primary amenorrhea, dyspareunia, recurrent pregnancy loss, and reproductive complications.
CONCLUSIONS: Women with non-obstructive reproductive tract anomalies present at various ages due to the asymptomatic nature or late symptom onset of certain conditions. An MRI is the gold standard in evaluation of such conditions to aid in confirming the müllerian variant. Each condition requires careful counseling because obstetric and gynecologic risks and consequences may differ. Treatment is individualized in cases of uterovaginal agenesis with both nonsurgical and surgical options available for neovagina creation. In cases of uterine or vaginal septae, the treatment timing may vary depending on patient history. Finally, in cases of non-obstructive communicating uterine horns, the risk of ectopic pregnancy is high in the remnant horn. Should a pregnancy occur in this small underdeveloped horn, therefore, excision is recommended.
Jennifer E Dietrich; Debra M Millar; Elisabeth H Quint
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Publication Detail:
Type:  Journal Article     Date:  2014-07-17
Journal Detail:
Title:  Journal of pediatric and adolescent gynecology     Volume:  27     ISSN:  1873-4332     ISO Abbreviation:  J Pediatr Adolesc Gynecol     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610774     Medline TA:  J Pediatr Adolesc Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  386-95     Citation Subset:  IM    
Copyright Information:
Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. All rights reserved.
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