MÜLLERIAN DUCT ANOMALIES INCLUDING THE RARE HERLYN-WERNER-WUNDERLICH SYNDROME AND REVIEW OF LITERATURE
SHRIYA GANJU *
Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla, HP, India.
ROHINI RAO
Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla, HP, India.
*Author to whom correspondence should be addressed.
Abstract
Müllerian duct anomalies (MDAs) encompass a wide range of developmental anomalies, resulting from non-development, defective fusion, or defects in regression of the septum during embryogenesis. The symptoms usually appear during menarche due to retrograde menstrual flow which is complicated by development of pelvic adhesions and endometriosis and infertility. Other common complications are; repeated first trimester spontaneous abortions, fetal intra-uterine growth retardation, fetal malposition, preterm labour and retained placenta. MDAs are also frequently associated with complex malformations of the renal axial skeletal system which are diagnosed late as they come across incidentally causing treatment delays. Timely diagnosis is important for surgically correctable forms of Müllerian duct alterations to treat infertility and improve the women’s quality of life. We present three cases of MDAs including one with renal agenesis, the rare Herlyn-Werner-Wunderlich syndrome.
Keywords: Müllerian duct anomaly, embryogenesis, Herlyn-Werner-Wunderlich syndrome, uterus didelphys, obstructed hemivagina, ipsilateral renal agenesis