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      Conduite à tenir devant un utérus didelphe associé à un hémivagin borgne Translated title: Management of a uterus didelphys associated with a blind hemivagina

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          Abstract

          L'utérus didelphe avec hémivagin borgne est une malformation rare, souvent diagnostiquée juste après les premières règles. La survenue d'un hématocolpos associée à une hématométrie et parfois un hématosalpinx est responsable de douleurs pelviennes et d'une dysménorrhée de plus en plus invalidante. Le diagnostic est posé par l’échographie pelvienne et selon l'urgence par l'imagerie par résonnance magnétique; l'agénésie rénale ipsilatérale est constante dans ce type de malformation. Le traitement consiste en une résection large de la cloison vaginale permettant ainsi un drainage continu de l'hémi utérus rétentionnel associé à une cœlioscopie objectivant les répercussions tubaires et pelviennes. Nous rapportons un cas d'utérus didelphe avec hémivagin borgne diagnostiqué à l’âge de 23 ans, nous discuterons à travers ce cas les aspects cliniques, diagnostiques et thérapeutiques de cette malformation utérine.

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          Most cited references10

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          Reproductive outcomes in women with congenital uterine anomalies detected by three-dimensional ultrasound screening.

          To determine reproductive outcomes in women with congenital uterine anomalies detected incidentally by three-dimensional ultrasound. We studied 1089 women with no history of infertility or recurrent miscarriage who were seen for a transvaginal ultrasound scan. They were screened for uterine abnormalities using three-dimensional ultrasound. We determined prevalence of miscarriage and preterm labor in women with normal and abnormal uterine morphology. We found that 983 women had a normally shaped uterine cavity, 72 an arcuate, 29 a subseptate, and five a bicornuate uterus. Women with a subseptate uterus had a significantly higher proportion of first-trimester loss (Zeta = 4.68, P <.01) compared with women with a normal uterus. Women with an arcuate uterus had a significantly greater proportion of second-trimester loss (Zeta = 5.76, P <.01) and preterm labor (Zeta = 4.1, P <.01). There were no other significant differences in pregnancy outcomes between women with normal and abnormal uterine morphology. This study shows the potential value of three-dimensional ultrasound and confirmed that women with congenital uterine anomalies were more likely to have adverse pregnancy outcomes than women with a normal uterus.
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            MR imaging diagnosis of uterovaginal anomalies: current state of the art.

            Uterovaginal anomalies are associated with a high incidence of decreased fertility and multiple obstetric problems. These anomalies are caused by alterations in development or fusion of the müllerian ducts. Uterovaginal anomalies are classified into three types: dysgenesis, vertical or lateral fusion defects, and unusual configurations. Systematic analysis of magnetic resonance (MR) images allows accurate morphologic demonstration and classification of uterovaginal anomalies, thereby indicating the appropriate treatment. The following parameters are recorded in MR images: uterine size, external fundal contour, intercornual distance, zonal anatomy, and presence of uterine or vaginal septa. Associated pelvic lesions or renal anomalies are to be reported. MR imaging allows diagnosis of obstructive uterovaginal anomalies; determining the site of obstruction is imperative for planning the proper surgical approach. MR imaging techniques, including planes, sequences, and the application of more recent advances, are discussed. Pelvic phase-array coils and endovaginal coils provide detailed images and can be problem-solving tools in complex anomalies. MR imaging findings associated with a variety of uterovaginal anomalies are shown. The author suggests a five-step approach for diagnosing uterovaginal anomalies with MR imaging. Copyright RSNA, 2003
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              Hematocolpos in double vagina associated with uterus didelphus: US and MR findings.

              The malformative syndrome of double vagina in association with uterus didelphus and kidney agenesis is a rare condition, often asymptomatic: if this condition is accompanied by imperforated obstructed hemivagina, the clinical manifestations depend on the presence of hematocolpos. MRI plays an important role for diagnosis because it allows to characterize the nature of the lesion and to evaluate the anatomical details of the uterine malformation. The authors describe this complex genital malformation and discuss the main US and MRI features.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                18 November 2012
                2012
                : 13
                : 56
                Affiliations
                [1 ]Service de gynécologie-obstétrique II, CHU Hassan II, Fès, Maroc
                [2 ]Service de radiologie, Chu Hassan II, Fès, Maroc
                Author notes
                [& ]Corresponding author: Fatima Zohra Fdili Alaoui, Professeur assistante, Service gynécologie obstétrique II, CHU Hassan II, Fès, Maroc
                Article
                PAMJ-13-56
                3549443
                23346270
                01216ed8-b422-4370-b24c-230c6a5b3e8f
                © Fatima Zohra Fdili Alaoui et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 September 2012
                : 02 November 2012
                Categories
                Case Report

                Medicine
                utérus didelphe,hémivagin borgne,hématocolpos,diagnostic,traitement chirurgical,pronostic,uterus didelphys,blind hemivagina,hematocolpos,diagnosis,surgical treatment,prognosis

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