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Congenital Uterine Anomalies

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Ultrasound Imaging in Reproductive Medicine
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Abstract

Congenital uterine anomalies are the most common anomaly of the female reproductive tract, affecting 3–8% of fertile and infertile women. Common categories of uterine anomalies are hypoplasia or agenesis, unicornuate, didelphys, bicornuate, septate and arcuate, and diethylstilbestrol-exposed. Although uterine anomalies are associated with adverse reproductive outcomes including recurrent pregnancy loss, preterm labor, and preterm delivery, healthy reproductive outcomes are possible. Females with obstructive uterine anomalies tend to present during adolescence due to pelvic pain or dysmenorrhea, and those with nonobstructive uterine anomalies may not be identified until evaluation of pregnancy loss, an obstetric complication, or infertility is initiated. Imaging modalities to evaluate congenital uterine anomalies include two-dimensional ultrasonography (2DUS), three-dimensional ultrasonography (3DUS), hysterosalpingography, saline infusion ultrasonography, and magnetic resonance imaging (MRI). As 3DUS is increasingly utilized in pelvic imaging, this modality is proving to be highly accurate in diagnosing uterine anomalies and may be equivalent to MRI. However, for more complex anomalies of the reproductive tract, additional imaging such as MRI may be warranted. Detailed imaging of the female reproductive tract is essential to make the correct diagnosis of a uterine anomaly, determine if surgical intervention is recommended, and educate the woman about the reproductive implications of the uterine anomaly.

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Rackow, B.W. (2019). Congenital Uterine Anomalies. In: Stadtmauer, L., Tur-Kaspa, I. (eds) Ultrasound Imaging in Reproductive Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-16699-1_8

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