Abstract
As most congenital uterine abnormalities are asymptomatic, the majority of them are detected incidentally. While most women with uterine anomalies have a normal reproductive outcome, some may experience adverse reproductive outcomes. Accurate diagnosis and correct classification help in the appropriate counselling of women about their potential reproductive prognosis and risks and for planning any intervention. Evaluation of the internal and external contours of the uterus is the key in making a diagnosis and correctly classifying a uterine anomaly. Considering this, the gold standard test has been the combined laparoscopy and hysteroscopy historically, albeit invasive. However, 3D ultrasound has now become the diagnostic modality of choice for uterine anomalies due to its high degree of diagnostic accuracy, less invasive nature and it being comparatively less expensive. While 2D ultrasound and HSG are adequate for screening for uterine anomalies, MRI and combined laparoscopy and hysteroscopy are reserved for diagnosing complex Mullerian anomalies. Imaging for renal anomalies is recommended if a uterine anomaly is diagnosed.
Highlights
IntroductionThe process of reproduction including sperm transport, embryo implantation, foetal growth and development and the process of labour and birth rely on a structurally and functionally normal uterus
Congenital uterine anomalies (CUA) are not uncommon, with the reported population prevalence rates in individual studies varying between 0.06% and 38%, and the observed wide variation is possibly due to the assessment of different study populations and the use of different diagnostic techniques [1]
While this review primarily aims to discuss screening and correctly classifying CUAs using various diagnostic modalities, we will briefly discuss embryology and different classifications of uterine anomalies
Summary
The process of reproduction including sperm transport, embryo implantation, foetal growth and development and the process of labour and birth rely on a structurally and functionally normal uterus. Any uterine abnormalities including congenital anomalies can influence some of these uterine functions adversely. While most women with uterine anomalies have a normal reproductive outcome, some may experience adverse reproductive outcomes, the underlying pathophysiological process is uncertain. Congenital uterine anomalies (CUA) are not uncommon, with the reported population prevalence rates in individual studies varying between 0.06% and 38%, and the observed wide variation is possibly due to the assessment of different study populations and the use of different diagnostic techniques [1]. Knowing Mullerian duct embryology will help to understand the type and classification of CUAs. While this review primarily aims to discuss screening and correctly classifying CUAs using various diagnostic modalities, we will briefly discuss embryology and different classifications of uterine anomalies
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