Uterine Size, Shape, Position, and Congenital Anamalies

Following menopause, the uterus typically becomes — than the premenopausal uterus

much smaller

Postmenopausal uterus. Sagittal (A) and transverse (B) views demonstrating an atrophic postmenopausal uterus (between calipers).

Changes in uterine size with age.

A newborn baby girl may have a thickened endometrium. This is caused by the —

stimulation of the baby’s endometrium by maternal hormones

The normal position of the uterus is considered to be —

anteversion or anteflexion

Anteversion describes the uterine position in which the body —

tilts forward or anteriorly, forming a 90-degree angle with the vagina

Anteflexion of the uterus denotes the position in which the uterine body —

folds forward, possibly coming in contact with the cervix

Retroversion of the uterus is the position in which the uterine body —

tilts backward or posteriorly, without a bend where the cervix and body meet

Retroflexion is the uterine position that results in the uterine body —

tilting backward and actually coming in contact with the cervix

The uterus that is located more on the left is referred to as a —

levoverted uterus

the uterus that is located on the right is referred to as —

dextroverted uterus

A bicornuate uterus, also referred to as bicornis unicollis, is a —

common uterine anomaly that is present when the endometrium divides into two endometrial cavities with one cervix, with a prominent concavity noted in the outline of the uterine fundus

The unicornuate uterus is present when the uterus has only —

one horn

The septate uterus, which is also a common Müllerian duct anomaly, describes a uterus that has —

two complete separate uterine cavities separated by an anteroposterior septum

The subseptate uterus, which is characterized by an incomplete septum, has a normal uterine contour with an —

endometrium that branches into two horns

The arcuate uterus is a subtle variant in which the endometrium has a —

concave contour at the uterine fundus

The uterus didelphys is —

complete duplication of the vagina, cervix, and uterus

anteverted uterus

retroverted uterus

anteflexed uterus

retroflexed uterus

The word part “colli” refers to the —

neck or cervix of the uterus

the word part “cornu” refers to the —

horn of the uterus

bicornis unicollis is interpreted as —

two horns with a cervix

bicornis bicollis is interpreted as —

two horns with a double cervix

Some studies claim that intrauterine — has resulted in the formation of congenital malformation of the uterus

exposure to diethylstilbestrol (DES)

DES was a —

drug administered to pregnant woman from the 1940s to the 1970s to treat threatened abortions and premature labor.

The female fetus exposed to DES in utero had an increased likelihood of developing a —

congenital uterine malformation

Congenital malformations have been linked to

menstrual disorders, infertility, and obstetric complications

Specifically, the septate uterus has an explicit connection with —

spontaneous abortion

hysterosalpingography, which is a radiographic study that utilizes contrast to evaluate the uterine cavity and fallopian tubes, was often performed on women with suggested —

congenital uterine malformations or who are suffering from infertility

Saline infusion sonohysterography, which may also be referred to as simply —, can be used to provide additional helpful information in regard to congenital uterine malformations

sonohysterography

For patients with a septate uterus, sonography can also aid in the resection of the septum during a —

hysteroscopic uterine septoplasty

— is said to be one of the most common Müllerian duct anomalies.

The septate uterus

double uterus (didelphys) and double vagina

uterus duplex bicornis

uterus bicornuate

uterus unicornuate

complete septate uterus

subseptate uterus

Septate uterus. Three-dimensional reformatting of a septate uterus in the coronal plane demonstrating the presence of two separate endometriums (short arrows) within the fundus (long arrow) of the uterus.

Didelphic uterus. A. Transverse transabdominal image of the cervix revealing two separate endocervical canals (arrows). B. Transverse transabdominal image of the upper uterus demonstrating a separate right and left uterine horn (arrows).

DES anomalies. Uterine anomalies associated with in utero diethylstilbestrol (DES) exposure. The classic anomaly is a T-shaped uterus.

the classic anomaly with DES exposure is

T-shaped uterus

Normal hysterosalpingogram. Radiograph of the female pelvis after the installation of a radiopaque compound into the uterine cavity.

3D of arcuate uterus. True coronal view of the uterus, obtained by reconstruction using 3D sonography, demonstrating the myometrium (M) in the uterine fundus dips down with a rounded configuration (arrow) into the endometrium, indicating an arcuate uterus. The fundus had a normal shape (arrowheads).

Congenital malformations of the vagina can lead to the

accumulation of fluid within the female genital tract secondary to an obstruction

Hydrocolpos describes the condition in which —

the vagina is distended with simple, anechoic fluid, and is seen more often in the neonatal period

As the vagina distends with fluid, excessive amounts may lead to further accumulation of the fluid into the uterus, a condition known as —

hydrometrocolpos

Patients may have blood components from menstruation retained in the uterine cavity or vagina, termed —

hematometra and hematocolpos

hematometrocolpos, a condition when

both the uterine cavity and vagina are filled with blood

Vaginal obstruction is frequently associated with the presence of an —

imperforate hymen in young girls.

Hydrocolpos. Simple appearing fluid is noted posterior to the urinary bladder (B) and inferior to the cervix (C) within the vagina (V) in this sagittal image of the neonatal pelvis.

Hematometra. The uterus is distended with echogenic fluid (f) representing blood

Hematocolpos. Sagittal image of a 12-year-old girl with cyclic pain demonstrating a blood-filled distended vagina (V).

The word part “colpo” refers to —

the vagina

the word part “metra” refers to —

the uterus

clinical findings of vaginal obstructions

1. Cyclic pelvic pain (often at the time of menses in adolescent girls)

2. enlarged uterus

3. abdominal pain

4. urinary retention

5. amenorrhea (adolescent girls)

Sonographic findings of vaginal obstructions

1. Distension of the uterus, vagina, or both with anechoic or complex fluid