Female Congenital Anomalies
These are congenital (present from birth) malformations of the female genital tract (vagina, cervix, uterus, fallopian tubes, and ovaries). They occur during embryonic development but may not become obvious until puberty or after.
These are caused by incomplete fusion of the tissues that make these organs (Mullerian and paramesonephric ducts).
When there is complete failure of fusion, the patient has two vaginas, two cervices and two uteruses. The fallopian tubes and ovaries are usually normal.
Partial fusion may result in a single vagina, a single cervix and two uteruses that are partially fused to each other. Almost any variation of this can (and has) happened.
Other anomalies include a uterus with a septum (wall inside), an arcuate uterus (heart shaped) and a unicornuate (one sided) uterus.
Depending on the specific abnormality, the result may be:
- Menstrual cramps
- Collection of blood in the abnormal structures causing pain
- Complications of pregnancy, including premature labor and abnormal presentations requiring cesarean section
Congenital abnormalities of the vagina include:
- Vaginal agenesis (absent vagina). Usually the uterus is absent but ovaries are present.
- Vaginal atresia (absent lower vagina). A normal uterus is usually present.
- Mullerian aplasia (nearly all the vagina and most of the uterus are absent). This may be associated with other anomalies (fused cervical vertebrae and middle ear defects).
- Transverse and longitudal vaginal septa (may be single or multiple and sometimes there are holes in the septa).
Any of these may be associated with abnormalities of the urethra.
Imperforate hymen completely obstructs the vaginal opening and prevents menstrual blood from getting out of the vagina. It may be congenital or acquired.
Cloacal Dysgenesis – This occurs when the outlets for the urinary, genital and intestinal tracts come out in or near the same place.
Ovaries may be congenitally absent or very small (ovarian agenesis or dysgenesis). This is most commonly caused by chromosomal abnormalities (usually absence of one X chromosome, known as Turner’s Syndrome)