Unicornuate uterus
Classification according to ICD-10 | |
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Q51.4 | Unicornuate uterus |
ICD-10 online (WHO version 2019) |
The uterus unicornis ("unicorned uterus") is a malformation of the uterus ( uterus ). It arises from the absence of one of the two Müller ducts , the merging of which creates the uterus in the fetus .
Frequency and risk
Uterus unicornis accounts for about a quarter of all congestive uterine malformations. The rate of miscarriages due to malformations of the uterus is reported very differently and is between 5 and 30 percent. With a unicornuate uterus, the risk of miscarriage is around 50 percent.
Classification
According to the AWMF guidelines, the term uterus unicornus in the broader sense comprises the following forms:
- (a) communicating, with a rudimentary 2nd horn
- (b) not communicating, with a rudimentary 2nd horn
- (c) without cavum, with rudimentary 2nd horn without cavum
- (d) no 2nd horn, uterus unicornis in the narrower sense
Diagnosis
Diagnosis is usually carried out by means of endoscopy , with hysteroscopy providing initial information. A differential diagnosis can be performed by laparoscopy .
therapy
Depending on the development of the rudimentary horn, therapy is possible:
- communicating horn with endometrium: no therapy possible (possibly coagulation of the horn, resection if hematometry is formed)
- non-communicating horn with endometrium: laparoscopic resection of the horn (risk of hematoma, high incidence of endometriosis)
- no cavum detectable in the rudimentary horn: no therapy possible
- no rudimentary horn detectable: no therapy possible
- Pregnancy in the rudimentary horn demonstrable: Laparoscopic resection of the rudimentary horn
It is not possible to improve fertility .
In addition to the unicornuate uterus, there are a number of other uterine malformations such as uterus arcuatus ("arched uterus"), uterus duplex ("double uterus") and uterus bicornis bicollis ("two-necked two-horned uterus").
literature
- Klaus Diedrich, Michael Ludwig, Georg Griesinger (Hrsg.): Reproductive medicine. Springer, 2013. ISBN 978-3-642-30181-0 .
- Adolf Kussmaul : About the deficiency, the stunting and doubling of the uterus. Verlag der Stahel'schen Buch- & Kunsthandlung, 1859.
- Thomas Römer: uterine malformations. Walter de Gruyter, 2011. ISBN 978-3-11-021310-2 . P. 52ff.
- Arnold Rosenburger: Six cases of unicornuate uterus including one with pregnancy in a stunted accessory horn. Junge & Sohn, Erlangen 1861.
Individual evidence
- ↑ Jörg Baltzer: Practice of Gynecology and Obstetrics: The complete practical knowledge in one volume. Thieme, Stuttgart 2006. ISBN 978-3-13-144261-1 . P. 406
- ↑ Baltzer: Practice of Gynecology and Obstetrics. P. 206
- ↑ AWMF
- ↑ a b Klaus Diedrich et al .: Reproductive Medicine. Springer, 2013. ISBN 978-3-642-30181-0 . P. 381