Complete septate uterus with cervical duplication and longitudinal vaginal septum: an uncommon mullerian anomaly

Authors

  • Pundalik K. Sonawane Department of Obstetrics & Gynecology, K.J. Somaiya Medical College, Mumbai, Maharashtra, India
  • Urvi C. Bhavsar Department of Obstetrics & Gynecology, K.J. Somaiya Medical College, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20151318

Keywords:

Mullerian anomaly, Infertility, Uterine septum, Double cervix

Abstract

The most commonly reported mullerian duct anomalies are septate, arcuate, didelphys, unicornuate or hypoplastic uteri. Here we describe a presentation of unusual mullerian anomaly. We report a case of 31 year old nulliparous woman with primary infertility married since 5 years with history of excision of longitudinal vaginal septum 2 years back. Clinical examination revealed two cervix. On ultrasound, she was diagnosed with single fundus with 2 uterine cavities and double cervix with complete septum within. Diagnosis was confirmed with hysterosalpingogram and MRI showing no communication between the two uterine cavities. On combined laproscopy and hysteroscopy, the septum was excised above the level of cervix transforming into a single cavity uterus with free bilateral spillage of fallopian tubes, keeping the two cervix intact. This anomaly is inconsistent with generally accepted understanding of mullerian development but fits within alternative hypothesis. Establishing an accurate diagnosis is essential for planning treatment and management strategies.

References

McBean J, Brumsted JR. Septate uterus with cervical duplication: a rare malformation. Fertil Steril. 1994;62(2):415-7.

Acien P. Incidence of Mullerian defects in fertile and infertile women. Hum Reprod. 1997;12:1372-6.

Chang AS, Siegel CL, Moley KH, Ratts VS, Odem RR. Septate uterus with cervical duplication and longitudinal vaginal septum: a report of five new cases. Fertil Steril. 2004;81(4):1133-6.

Balasch J, Moreno E, Martinez-Román S, Moliní JL, Torné A, Sánchez-Martín F, et al. Septate uterus with cervical duplication and longitudinal vaginal septum: a report of three new cases. Eur J Obstet Gynecol Reprod Biol. 1996;65(2):241-3.

Sharara FI. Complete uterine septum with cervical duplication, longitudinal vaginal septum and duplication of a renal collecting system. A case report. J Reprod Med. 1998;43(12):1055-9.

Giraldo JL, Habana A, Duleba AJ, Dokras A. Septate uterus associated with cervical duplication and vaginal septum. J Am Assoc Gynecol Laparosc. 2000;7(2):277-9.

Ribeiro S, Yamakami L, Tormena RA. Septate uterus with cervical duplication with longitudinal vaginal septum. Rev. Asso Med Bras. 2010;56(2):254-6.

Buttram VC, Gibbons WE. Müllerian anomalies: A proposed classification (an analysis of 144 cases). Fertil Steril. 1979;32:40-6.

Musset R, Muller P, Netter A, Solal R, Vinourd JC, Gillet JY. Etat du haut appareil urinaire chez les porteuses de malformations uterines. Etude de 133 observations. Presse Med. 1967;75(26):1227-32.

Ergun A, Pabuccu R, Atayv, Kycuk T, Duru NK. Three sisters with septate uteri: another reference to bidirectional theory. Hum Reprod. 1997;12(1):140-2.

Patton PE, Novy MJ, Lee DM, Hickok LR. The diagnosis and reproductive outcome after surgical treatment of the complete septate uterus, duplicated cervix and vaginal septum. Am J Obstet Gynecol. 2004;190(6):1669-75.

Saygili-Yilmaz ES, Erman-Akar M, Bayar D, Yuksel B, Yilmaz Z. Septate uterus with a double cervix and longitudinal vaginal septum. J Reprod Med. 2004;49(10):833-6.

Üstün Y, Engin Üstün Y, Meydanii MM, Atmaca R, Kafkasli A. Hysteroscopic ballon technique for correction of complete uterine septum. J Turkish- German Gynecol Assoc. 2006:229-31.

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Published

2017-02-19