Distribution of female genital tract anomalies in two classifications.
OBJECTIVE
This study assessed the distribution of Müllerian duct anomalies in two verified classifications of female genital tract malformations, and the presence of associated renal defects.


METHODS
621 women with confirmed female genital tract anomalies were retrospectively grouped under the European (ESHRE/ESGE) and the American (AFS) classification. The diagnosis of uterine malformation was based on findings in hysterosalpingography, two-dimensional ultrasonography, endoscopies, laparotomy, cesarean section and magnetic resonance imaging in 97.3% of cases. Renal status was determined in 378 patients, including 5 with normal uterus and vagina.


RESULTS
The European classification covered all 621 women studied. Uterine anomalies without cervical or vaginal anomaly were found in 302 (48.6%) patients. Uterine anomaly was associated with vaginal anomaly in 45.2%, and vaginal anomaly alone was found in 26 (4.2%) cases. Septate uterus was the most common (49.1%) of all genital tract anomalies, followed by bicorporeal uteri (18.2%). The American classification covered 590 (95%) out of the 621 women with genital tract anomalies. The American system did not take into account vaginal anomalies in 170 (34.7%) and cervical anomalies in 174 (35.5%) out of 490 cases with uterine malformations. Renal abnormalities were found in 71 (18.8%) out of 378 women, unilateral renal agenesis being the most common defect (12.2%), also found in 4 women without Müllerian duct anomaly.


CONCLUSIONS
The European classification sufficiently covered uterine and vaginal abnormalities. The distribution of the main uterine anomalies was equal in both classifications. The American system missed cervical and vaginal anomalies associated with uterine anomalies. Evaluation of renal system is recommended for all patients with genital tract anomalies.
School of Medicine, University of Tampere, Tampere, Finland; Department of Obstetrics and Gynecology, University Hospital of Tampere, Tampere, Finland. Electronic address: pentti.heinonen@fimnet.fi.
Pentti K
PK
Heinonen
D002584:Cervix Uteri / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014564:Urogenital Abnormalities / Q000145:classification* / Q000000981:diagnostic imaging*; D014599:Uterus / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014621:Vagina / Q000002:abnormalities* / Q000000981:diagnostic imaging
Congenital uterine malformation; Female urogenital tract; Müllerian duct anomaly; Renal anomaly; Vaginal anomaly