Gómez MYO, Chaya HM, Hugues GMG, Torres EJC

Language: Spanish
References: 11
Page: 151-155
PDF size: 313.65 Kb.

ABSTRACT

The didelphys uterus is an anomaly that occurs due to a defect in the medial fusion of the paramesonephric ducts; pregnancy can happen and develop normally in these patients. The prevalence of these abnormalities is about 5% in the general population, however, it increases to 13-25% in women with recurrent pregnancy loss. With this malformation specifically, the most common complications include recurrent miscarriage because cervical incompetence and increased incidence of pre-term caesarean delivery. Diagnosis is made by transabdominal ultrasound, nevertheless, MRI imaging plays an important role in the preoperative setting of this group of anomalies, since in recent years it has shown which patients will have a greater benefit from surgical treatment. Treatment varies from a vaginal septum resection, to a metroplasty. The purpose of this paper is to report the case of a 25-year-old primigravid patient, with prior diagnosis of uterus didelphys bicollis with septate vagina who comes at 15.5 weeks of gestation, who is admitted to undergo resection of vaginal septum and placement of prophylactic cerclage in «8».

REFERENCES

1. Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001; 7 (2): 161-174.

2. Vercellini P, Daguati R, Somigliana E. Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertil Steril. 2007; 87 (4): 719-724.

3. Chan YY, Jayaprakasan K, Tan A. Reproductive outcomes in women with congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol. 2011; 38: 371-382.

4. Gholoum S, Puligandla PS, Hui T, Su W, Quiros E, Laberge JM. Management and outcome of patients with combined vagi­nal septum, bifid uterus, and ipsilateral renal agenesis (Herly Werner-Wunderlich syndrome). J Pediatr Surg. 2006; 41: 987-992.

5. James DK, Steer PJ, Weiner CP, Gonik B. High risk, pregnancy management options. 3rd ed. London: Elsevier; 2005. pp. 107-108.

6. Leo L, Arduino S, Febo G, Tessarolo M, Lauricella A, Wierdis T et al. Cervical cerclage for malformed uterus. Clin Exp Obs­tet Gynecol. 1997; 24 (2): 104-106.

7. Golan A, Langer R, Wexler S, Segev E, Niv D, David MP. Cervical cerclage: its role in the pregnant anomalous uterus. Int J Fertil. 1990; 35: 164-170.

8. Simón C, Martinez L, Pardo F, Tortajada M, Pellicer A. Müllerian defects in women with normal reproductive outcome. Fertil Steril. 1991; 56 (6): 1192-1193.

9. Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology 1992; 183: 795-800.

10. Junqueira BL, Allen LM, Spitzer RF, Lucco KL, Babyn PS, Doria AS. Müllerian duct anomalies and mimics in children and adolescents: correlative intraoperative assessment with clinical imaging. Radiographics. 2009; 29: 1085-1103.

11. Steinkeler JA, Woodfield CA, Lazarus E, Hillstrom MM. Female infertility: A systematic approach to radiologic imaging and diagnosis. Radiographics. 2009; 29: 1353-1370.