Congenital utero-vaginal anomalies

There are many classification systems for congenital utero vaginal anomalies. These include

• Buttram and Gibbons classification ²
• American Fertility Society (AFS) classification
• modified Rock and Adam - AFS classification

Modified Rock and Adam - AFS classification

This classification divides congenital uterine anomalies into 4 main types which include

• class I : dysgenesis of Müllerian ducts
  • includes agenesis or hypoplasia of the müllerian duct derivatives: the uterus and upper two-thirds of the vagina
  • the most common form is the Mayer-Rokitansky-Kuster-Hauser syndrome - is combined agenesis of the uterus, cervix, and upper portion of the vagina.
• class II : disorders of vertical fusion.
  • these anomalies are due to failure of fusion of the müllerian system with the sinovaginal bulb.
  • they include cervical dysgenesis and obstructive and nonobstructive transverse vaginal septa
• class III : disorders of lateral fusion.
  • describes anomalies that result in a duplicated or partially duplicated reproductive tract.
  • these disorders are due to impaired fusion and / or septal resorption of fusing Müllerian ducts attempting to form the uterus, cervix, and upper vagina.
  • it includes anomalies due to failure of fusion of the paired müllerian ducts (as in didelphic and bicornuate uteri) and failure of midline septum resorption after fusion (as in septate uterus).
  • disorders due to lateral fusion defects are further subclassified into 
    • a : symmetric non-obstructive forms seen in five types: unicornuate, bicornuate, didelphic, septate, and DES-related uteri and 
    • b : asymmetric obstructive forms seen in three types: unicornuate uterus with obstructed horn, double uterus with unilaterally obstructed horn, and double uterus with unilaterally obstructed vagina.
• class IV : unusual configurations and combinations of defects

See also

• Mullerian duct anomaly classification
• congenital uterine anomalies