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Septate versus bicornuate uterus

Case contributed by Dr Bruno Di Muzio


26 years old woman with difficulty in conceiving. Observation: In this case we don`t have other modality of image to make this differentiation, the patient did not bring previous ultrasound.

Patient Data:

Age: 26
Gender: Female
Race: Other
Modality: X-ray

Case Discussion:

Congenital abnormalities of uterine shape are due to abnormal fusion of the müllerian ducts during early (6 - 12 weeks) gestation.

If the two müllerian ducts do not completely fuse, a bicornuate uterus is formed. All bicornuate uteri will demonstrate a cleft in the outer contour of the fundus. The amount of fusion of the müllerian ducts can vary from minimal union to nearly complete union. When the two ducts fuse but there is incomplete resorption of the intervening septum, a septate uterus results. The length of the septum can vary depending on the degree of resorption (complete vs partial septum), similar to the bicornuate uterine anomaly. Unlike the bicornuate uterine deformity, the septate and arcuate deformities have a normal outer uterine contour. Optimal visualization of the outer contour is important in differentiating among these various anomalies.

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