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Submitted by Amer Hussien, M.D & Hesham Al-Inany M.D
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Approximately 10% of infants are born with some abnormality of the
genitourinary system.
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Approximately 10% of infants are born with some abnormality of the
genitourinary system and anomalies in one system are often mirrored by
anomalies in another system. A number of genitourinary defects may result
from abnormalities in the embryological process. These may occur spontaneously
or are induced by agents as DES.
Although developmental anomalies of the female genital tract are not
often encountered in obstetrics, minor defects may result in an increased
incidence obstetric problems
Genesis and Classification
The principal groups of deformities arise from 4 types of embryological
defects:
- Dysgenesis or complete agenesis
- Failure of vertical fusion
- Failure of lateral fusion of the mullerian ducts which may result
in symmetrical or asymmetrical abnormalities
- Unusual configuration of vertical and lateral fusion .

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Currently there is no satisfactory classification. The terminology
is often complicated with latin terms. A simple classification for Mullerian
duct anomalies was suggested by Buttram and Gibbons (1979) in the 19th
edition of Williams obstetrics:
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I. Segmental Mullerian agenesis or hypoplasia
- Vaginal
- Cervical
- Fundal
- Combined
II. Unicornuate uterus
- With rudimentary horn
- With endometrial cavity
- Communicating
- Non-communicating
- Without endometrial cavity
- Without a rudimentary horn
III. Uterine didelphys
IV. Bicornuate uterus
- Complete (division to the internal os)
- Partial
- Arcuate
V. Septate
- Complete (septum to the intrnal os)
- Partial
VI. Diethylstilbestrol
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The authors stressed that vaginal anomalies may exist alone
or in association with other Mullerian anomalies , but vaginal anomalies
were not classified because they were not associated with fetal loss.
Vaginal anomalies using their scheme were most often associated with classes
III and IV.
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