Picture of a unicornuate uterus

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Posted by Master, Doctor Nguyen Le Thao Tram - Doctor of Diagnostic Imaging - Department of Diagnostic Imaging - Vinmec Nha Trang International General Hospital
Unicornuate uterus is a type of Müllerian fallopian tube defect (class II) that is characterized by a banana-shaped uterus and leads to a solitary fallopian tube.

1. What is the disease of the unicornuate uterus?

Unicornuate uterus (unicornis unicollis) is a type of Müllerian fallopian tube defect (class II) characterized by a banana-shaped uterus and leading into a solitary fallopian tube.
Epidemiologically, unicornuate uterus may account for ~10% (6-13%) of all uterine malformations and wherein the risk of infertility is approximately 12.5% ​​(range 5-20%). ) cases.
Pathologically, a unicornuate uterus is caused when one Müllerian duct fails to elongate, while the other develops normally. Regarding embryo-embryonic predominance, the unicornuate uterus is usually located on the right side, but this has not yet been explained, and may or may not be with or without rudimentary horns.

2. Subclassification of unicornuate uterus

According to the American Fertility Association, unicornuate uterus can be further divided into the following subgroups:

2.1. Type a: with rudimentary horns

a1: horn containing endometrium a1a: rudimentary horn bilaterally communicating and containing endometrium (10%) a1b: primitive horn containing endometrium bilaterally and containing endometrium (22%) a2: horn contralateral side without endometrial cavity (33%)

2.2. Type b: no rudimentary horns

Unicornuate uterus in type b accounts for (35%)

3. Lesions associated with unicornuate uterus

3.1. Kidney abnormalities

Renal malformations are more commonly associated with the unicornuate uterus than with other Müllerian tubular malformations and are present in 40% of cases, of which renal aplasia is common. Renal abnormalities are always on the same side as the rudimentary horns of the uterus.

3.2. Menstrual blood stasis

Menstrual blood stasis in rudimentary horns due to lack of communication with endometrial cavity.
In addition, damage to the unicornuate uterus can cause primary infertility.

4. Unicorn uterus picture

4.1. Uterine and fallopian tube scan

The endometrial cavity is usually banana-shaped (except type a, which may have a lacunae), tapered at the tip, and drains into a single fallopian tube. In addition, hysterosalpingogram shows that the uterus is often deviated from the midline.

4.2. Supersonic

Unicornuate uterus can be difficult to detect on uterine ultrasound. However, the image can show the uterus shrinking to one side.

4.3. MRI scan

Some of the features of a unicornuate uterus that may show up on MRI are as follows: long and curved uterus, banana-shaped ectopic contour, reduced uterine volume, and asymmetrical structure, however The anatomy of the uterus remains normal.

5. Treatment and prognosis of unicornuate uterus

Among the Müllerian duct malformations, the unicornuate uterus is considered to have a poor obstetric prognosis. The rate of spontaneous miscarriage is reported to range from 41-62%. Preterm birth rates in women with a unicornuate uterus have been reported to range from 10 to 20%. Fetal survival is ~40% (range 38-57%).
In short, unicornuate uterus (also known as unicornuate uterus) is a condition where the uterus is only 1/2 the size of a normal uterus and has only 1 fallopian tube. Women with a single uterus often have difficulty conceiving naturally and often receive assisted reproduction by in vitro fertilization or insemination. Therefore, women of reproductive age need to have a gynecological examination to promptly detect the risks and abnormalities of the uterus so that the doctor can guide the examination, advice and intervention when necessary.
Vinmec International General Hospital is currently a prestigious medical facility in Vietnam. There is a team of professional, well-trained and experienced doctors, a complete and modern medical equipment system, especially with fallopian tube X-ray machines, ultrasound machines. , international standard MRI machine helps doctors detect uterine abnormalities early, and accurately assess fertility, thereby advising couples to implement assisted reproductive techniques. advanced, ensuring parenthood in the future.

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References:
https://radiopaedia.org/articles/unicornuate-uterus