Congenital Uterine Anomalies Ultrasound Reporting | Didelphys, Bicornuate, Unicornuate Uterus USG

*Cases
Uterus Didelphys - 0:00
Bicornuate Uterus - 3:35
Unicornuate Uterus - 7:05
Septate Uterus - 9:37
Arcuate Uterus - 12:16

Ultrasound Reports

Uterus Didelphys:
Clinical Information: The patient presents with a history of irregular menses and dysmenorrhea. Previous medical records indicate unexplained infertility.
The pelvic ultrasound was performed transabdominally and transvaginally to evaluate the uterine structure and endometrium.

Findings

Uterus: The uterus appears to be duplicated with two distinct uterine bodies, each with its own cervix, consistent with a diagnosis of uterus didelphys. Each uterine cavity measures approximately 7 cm in length and displays a normal myometrial echo pattern without evidence of leiomyoma or focal lesion.
Right Uterus: The right uterine body shows a normal endometrial stripe measuring 3 mm in thickness. No adnexal mass or free fluid is observed in the right adnexa.
Left Uterus: The left uterine body similarly demonstrates a normal endometrial stripe, also measuring 3 mm. A small, simple ovarian cyst is noted on the left ovary, measuring approximately 2 cm. No significant free fluid or adnexal mass is present in the left adnexa.
Ovaries: Both ovaries are visualized and appear normal in size and morphology. The aforementioned simple cyst is seen on the left ovary. The right ovary shows normal follicular development for the patient’s menstrual cycle phase.

Impression:
Uterus didelphys with two distinct uterine bodies and cervixes.
Normal ovaries with a small simple cyst on the left ovary.
No evidence of intrauterine pregnancy at the time of scan.

Recommendations:
Further evaluation with magnetic resonance imaging (MRI) may be beneficial for comprehensive anatomical mapping. Consideration of a fertility consultation to discuss reproductive options and management. Regular follow-up is recommended to monitor the simple cyst on the left ovary.

Bicornuate Uterus:
Clinical Information: The patient presents with a history of recurrent miscarriages. She has been referred for further evaluation of uterine anomalies suspected in previous pelvic examinations.

Findings:
Uterus: The uterus is irregular in shape, displaying a prominent indentation on the fundal contour that extends towards the cervical canal, consistent with a bicornuate uterus. This configuration is characterized by two distinct uterine horns, which are well delineated in the 3D coronal view, confirming the suspicion of a bicornuate uterine anomaly.
Right Horn: Measures approximately 8 cm in length and 4 cm in width.
Left Horn: Measures approximately 7.5 cm in length and 3.8 cm in width.
The myometrial echotexture is homogenous, with no evidence of myomas or focal lesions within either uterine horn.
Endometrial Stripe: The endometrial linings within both horns appear normal, with thickness measurements consistent with the patient's phase in the menstrual cycle: approximately 5 mm in both horns.
Ovaries: Both ovaries are visualized and appear normal in size, position, and morphology. No adnexal masses or significant free fluid is noted.

Impression:
Bicornuate uterus with two distinct uterine horns, as confirmed by 3D ultrasound in the coronal view.
Normal endometrial stripes within both uterine horns.
No evidence of intrauterine pregnancy or abnormality within the ovaries.

Recommendations:
Given the patient’s history of recurrent miscarriages, the identification of a bicornuate uterus may have clinical significance regarding future pregnancy management. It is advisable to:
Discuss reproductive options and potential interventions with a fertility specialist.
Consider a follow-up MRI for further anatomical clarification and to assist in planning for any surgical intervention, if deemed necessary.
Schedule regular prenatal monitoring in the event of future pregnancies to manage potential complications associated with the bicornuate uterus.

Unicornuate Uterus:
Clinical Information: The patient presents for evaluation due to primary infertility and a history of irregular menstrual cycles. Previous assessments suggested a possible congenital uterine anomaly.
Technique: The examination was performed via both transabdominal and transvaginal approaches to comprehensively assess the uterine structure. 3D imaging was utilized to enhance the evaluation of the uterine morphology, with a focus on the coronal plane for detailed visualization.

Findings:
Uterus: The uterus is observed to be smaller than normal with a single horn, indicating a unicornuate uterus. This configuration lacks the typical pear shape, appearing elongated and curved. The 3D coronal view distinctly showcases the absence of the second uterine horn, confirming the unicornuate nature of the uterus.

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