Clinica de Diagnostico por Imagem, Rio de Janeiro, Brazil

The diagnosis of uterine anomalies is important in infertility patients but also in pregnant woman because of the association with obstetrical complications such as abortion, cervical incompetence, dystocia, ectopic pregnancy, intrauterine growth restriction, premature labor and malpresentation of the placenta.

The most common congenital uterine malformations arise from defects in paired müllerian duct development, fusion or resorption. They have been estimated to occur in 5% of women. The kidneys should be carefully evaluated because there is a common association with renal anomalies. The bicornuate uterus has two fundi. Uterus didelphus has two fundi, two cervical canals and two vaginal canals. Both uterus"s are associated with a low prevalence of fertility complications.

3D ultrasound and MRI have been used as an adjunct to 2D ultrasound. They offer additional images (coronal views) of the uterus which can help in the diagnosis of uterine anomalies. Our objective is to present images of bicornuate and didelphus uterus"s at 13th weeks .

Bicornuate uterus at 13 weeks gestation

Left image: The coronal plane (3D) demonstrates the midline sagittal groove. The fetus is in the left cavity. In this case, there is a single cervical canal (unicolis) and asymmetry of the uterine horns.

Right image: The fetal head is seen in the left cavity.

Uterus didelphus at 13 weeks

References:

1. Ayida G, Kennedy S, Barlow D, Chamberlain P. Contrast sonography for uterine cavity assessment: a comparison of conventional two-dimensional with three-dimensional transvaginal ultrasound; a pilot study. Fertil Steril 1996; 66: 848-50.
2. Jurkovic D, Gruboeck K, Tailor A, Nicolaides KH. Ultrasound screening for congenital uterine anomalies. Br J Obstet Gynaecol 1997; 104: 1320-1.
3. Li S, Qayyum A, Coakley FV, Hricak H. Association of renal agenesis and mullerian duct anomalies. J Comput Assist Tomogr 2000; 24: 829-34.