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Submitted by Amer Hussien, M.D & Hesham Al-Inany M.D

Congenital anomalies of the uterus

Approximately 10% of infants are born with some abnormality of the genitourinary system.


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Embryology of female genital system
Gametogenesis: a basic review


DES-related Mullerian abnormalities

Neoplastic : Vaginal clear cell adenocarcinoma in 0.14-1.4 % of exposures and small cell carcinoma of the cervix and CIN

Structural :

1. Vagina and cervix (1/4 of cases) :

- Transverse septa, vaginal adenosis, circumferential ridge in the vagina and cervix and cervical collars

2. Uterine (2/3 of cases) :

Smaller cavities, T-shaped cavities, and shortened upper uterine segments . About 1/2 of uterine defects are associated with cervical defects specially a hypoplastic cervix

3. Tubal : Shortening , narrowing and absence of fimbriae .

Reproductive performance :

- Lower conception rates

- Increased incidence of abortion : due to structural anomalies and cervical incompetence

- Increased incidence of ectopic pregnancy : due to tubal and uterine anomalies

- Infertility : due to cervical hypoplasia and atresia 

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