A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
Congenital malformations are found in all parts of the genital tract.
Some of the more common forms, like arrested development of the uterus,
have been referred to in the previous pages. Others will briefly be
considered here. Reference to the method of development of the sexual
organs will elucidate this subject.
The Fallopian tubes, the uterus, and the vagina are developed from two
embryonic structures called the ducts of Müller. These ducts become
fused, first at the lower extremity, between the sixth and eighth
weeks of fetal life (Fig. 175). The early genital tract thus formed is
consequently divided throughout by a septum, which normally disappears
during fetal development, so that there results one vaginal and uterine
tract, from which the Fallopian tubes branch.
[Illustration: FIG. 175.--Diagrams showing the development of the
vagina and the uterus from Müller’s ducts.]
The most important malformations of the vagina and the uterus arise
from arrest, at any stage, of this normal developmental process.
Very rarely the uterus is completely absent, or it may be represented
by a small band of muscular and connective tissue stretched across the
pelvis. In other cases the cervix is well formed, while the body of the
uterus is but poorly developed.
We have seen that this condition is often associated with pathological
anteflexion of the uterus.
=Uterus Unicornis.=--Sometimes there is arrest in the development
of one of Müller’s ducts, so that the uterus becomes one-sided or
one-horned and presents only one formed Fallopian tube. In such a case
both ovaries may be present.
=Uterus Didelphys.=--Müller’s ducts may unite only as far as the top of
the vagina, no fusion whatever taking place in the uterine portion. In
such a case two separated uterine bodies are produced; the condition of
double uterus exists (Fig. 176).
[Illustration: FIG. 176.--Uterus didelphys and double vagina.]
=Uterus Bicornis Duplex.=--In this variety of malformation development
has proceeded a step farther than in the preceding variety. The
uterine bodies have become externally united. There is, however, no
fusion of the cavities. Two cavities are present, opening into a double
vagina.
=Uterus Bicornis Unicollis.=--Here the development of the cervix and
the lower part of the uterus is normal. The upper parts of the body of
the uterus have not become fused, and diverge sharply from each other.
The organ is two-horned (Fig. 177).
[Illustration: FIG. 177.--Uterus bicornis unicollis (Winckel).]
=Uterus Cordiformis.=--In this variety the two halves of the uterus
are united throughout. Externally on the fundus there appears a slight
depression, which, with the broad body of the uterus, demonstrates the
imperfection of development. The name is derived from the resemblance
to the conventional heart-shape.
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