Table 1.
Summary table for uterus didelphys variations
| Etiology | Complete nonfusion of uterovaginal horns |
| Incidence | 1 per 1000 live births |
| Age Predilection | Uterus didelphys with obstruction in a patient presenting at menarche with cyclical dysmenorrhea and pelvic mass |
| Risk Factors | Genetics Majority of cases sporadic or multifactorial in origin May be caused by an autosomal dominant or recessive gene in certain cases Hepatocyte nuclear factor (HNF-1) β mutations reported in association with renal anomalies and diabetes |
| Anatomic Types | American Fertility Society classification Class I: Segmental agenesis, hypoplasia Occurs in a variety of forms Complete form most common (Mayer-Rokitansky-Kuster-Hauser syndrome) Class II: Unicornuate uterus May have rudimentary horn, which may or may not communicate with main uterine cavity Class III: Uterus didelphys Class IV: Bicornuate uterus Class V: Septate uterus Class VI: Arcuate uterus Class VII: DES exposure |
| Treatment | Expectant Metroplasty leaving duplicated cervix intact in selected patients with recurrent spontaneous abortions and premature deliveries Traditionally performed abdominally via a Pfannenstiel approach (e.g., Strassman metroplasty) Currently performed by a combined hysteroscopic and laparoscopic approach Benefits of metroplasty unclear Hysteroscopic resection of vaginal septum in patients with an obstructing vaginal septum |
| Prognosis | Generally good ≈ 25% of women with uterine anomalies have reproductive problems ≈ 3% of women with repeated pregnancy loss |
| Findings on Imaging |
MR Findings
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