hypoplasia uterus - this is the most "popular" anomaly of the uterus, sometimes congenital nature.The essence of the process of uterine hypoplasia is underdevelopment, that is, its size mismatch age norm.Weakly expressed form of hypoplasia of the uterus is the most common.
The incidence of congenital malformations of the uterus, and including hypoplasia, largely underestimated, since in some cases their primary diagnosis does not give an accurate picture of the nature and form of the anomaly.
Uterus adult woman shows smooth muscle hollow body is shaped like an inverted pear.In the uterus body is clearly distinguished and the bottom (wide upper part) and the neck (narrower bottom).The body is connected to the neck of the uterus through the isthmus.Available for inspection in the mirror of the cervix is referred to as vaginal.The uterus is the pelvic cavity retained by uterine ligaments.
cervix is part of the uterus, it is not a separate body and is modified to varyin
Nature gave women the unique body for pregnancy and childbirth.The muscular wall of the uterus is a very powerful and flexible, it can not only stretch many times and hold the fruit of almost 5 kg during pregnancy, but also to push it in the process of childbirth.
uterus begins to form in the fifth week of the embryo and grows very slowly up to 9 - 10 years of age.The rapid growth of the uterus begins after 10 years and reaches its normal physiological parameters to the period of puberty, ie 13 - 14 years.The process of proper development of the uterus can be broken at the beginning, when she is still in the womb.It is much more common hypoplasia of the corpus uteri, is not related to prenatal developmental disabilities.
If the uterus of an adult woman does not meet the age norm, it is possible to speak about its underdevelopment, or hypoplasia.Before making such a verdict, it is necessary to take into account not only the age of the patient and the average values of the normal size of the uterus: after birth (especially multiple), the uterus increases in size, while the miniature uterus nulliparous women may have dimensions corresponding to the lower limit of normal.Average statistical data determine the minimum size of the uterus as a 3.8 cm (body length) x 2.7 cm (thickness of the body) x 3.7 cm (width of the body).
uterine hypoplasia rarely occurs as the only symptom.In most cases, it is accompanied by a delay in sexual development of adolescents, menstrual disorders of different nature until amenorrhea, infertility, polycystic ovaries.
When genetic and chromosomal abnormalities (eg Turner syndrome) in girls found hypoplasia of the uterus and ovaries as a manifestation of delayed puberty.
reasons hypoplastic uterus
cause of congenital hypoplasia of the uterus are the disruption of the normal development of the embryo, which may be associated with hereditary (genetic) abnormalities or effects on the growing fetus adverse factors.
much more common hypoplasia of the uterus, is not related to congenital abnormalities.The reasons for the "acquisition" hypoplasia is a great variety, these include:
- Any CNS (area managers pituitary - hypothalamus) traumatic, toxic or infectious nature, stresses (conflicts at school and / or family, emotional distress), epilepsy;
- Tumors of the pituitary gland and the hypothalamus, leading to disruption of hormonal regulation of normal maturation of genitals;
- Heavy extragenital diseases - chronic renal or hepatic insufficiency, uncompensated heart diseases, etc.;
- Endocrine diseases - diabetes, hypothyroidism, hyperprolactinemia, etc .;
- Dishormonal state due to the defeat of the ovaries after suffering childhood infections (mumps, German measles, etc.) or against ovarian cysts and tumors.Besides, underdevelopment of the uterus may occur against ovarian hypoplasia themselves, in which case the ovarian and uterine hypoplasia will be present in the composition syndrome delayed puberty;
- underweight due to poor nutrition or irrational diets;
- drug use, alcohol, psychotropic drugs, smoking;
- Traumatic surgery in children with ovarian follicular damage to the unit or removal of the ovaries;
- By the underdevelopment of genitals lead and increased physical activity not related to individual physiological data (ballet, gymnastics, figure skating and other).Some parents are showing excessive zeal in the education of girls, writing them in all sorts of clubs and societies are not proportionate with the physical and emotional possibilities of the child.As a result, the child's body begins to experience total stress has a negative impact on the development of the genital organs;
- Chronic infectious diseases.Among patients with hypoplasia of the uterus a lot of sickly girls;
- Hereditary predisposition.Have underdeveloped womb (or uterus and appendages) in the immediate family (mother, sister) increases the chances of similar abnormalities in girls during puberty.
Symptoms and signs of the uterus hypoplasia
congenital hypoplasia of the uterus refers to malformations genitalia and diagnosed in early childhood.Typically, these children are examined and treated, together with endocrinologists, pediatricians and geneticists.
gynecologists More often have to deal with non-congenital form of uterine hypoplasia.The most common reasons for treatment to the gynecologist are:
- If the girl has never had periods up to 16 years of age or started much later than this age;
- menstrual irregularities.Irregular menstruation, sometimes painful, the number of lost blood from some very small, while others, conversely, heavy;
- Primary infertility, premature termination of pregnancy at different stages (from abortion to premature birth).
Underdevelopment of the uterus and vagina is a particular manifestation of the general infantilism.Infantile girl, usually short, fine-boned, with narrow hips and flat buttocks, poorly developed breasts and lean body hair under the armpits and pubic.
During the conversation, you can detect the presence of predisposing factors and adverse effects on the body as a child.
gynecological examination results depends on the clinical situation.If hypoplastic uterus expressed slightly, the doctor can only suspect its existence on the basis of the following signs - the small size of the uterus and its excessive deviation of the anterior (giperantefleksiya) to form an acute angle between the body and the neck.
Girls with the general infantilism revealed signs of genital infantilism: scant body hair pubic little vulva and labia immature, short and narrow vagina with underdeveloped arches and a small folding, an abnormal ratio of the size of the uterus and cervix.
Hormonal examination is conducted for all patients with hypoplasia of the uterus to establish violations of the production of sex steroids of various kinds.In women with anovulation infertility revealed.Additionally examined thyroid hormone function.
Ultrasound scanning (US) pelvic provides much more information about changes in the uterus and appendages than a pelvic examination and given to all patients with suspected genital malformations.Direct ehopriznaki hypoplastic uterus is crucial at a definitive diagnosis.Reliable ehopriznaki hypoplasia of the uterus is as follows: the size of the uterus does not correspond to age norm (less), the ratio of broken neck and body of the uterus, excessive "bend" in front of the uterus.Along with these changes, it can be identified undeveloped ovaries and fallopian tubes are crimped.
In a study of patients with hypoplasia of the uterus is sometimes carried out X-ray examination - hysterosalpingography.It allows you to make a differential diagnosis between infantile uterus and uterine hypoplasia.
Consultation related professionals is carried out in case of a combination with hypoplastic uterus neginekologicheskimi diseases.
Degrees hypoplastic uterus
The formation of the uterus is very long and is influenced by many factors.Damage should regulate the growth of the uterus may occur at various stages - it can be a time of initial tab body at the stage of the embryo or uterus can stop in the development at the stage of puberty.Time damaging normal mechanisms of the uterus and determine the very nature of the (extent) of underdevelopment:
- hypoplasia of the uterus 1 degree .The most severe underdevelopment of the uterus is rudimentary or embryonic, the uterus.Its presence indicates that the uterus is not originally been formed correctly and is not able to grow in the future.Length rudimentary uterus is less than 1 - 3 cm, and its length is half of the neck.Such a situation is extremely rare and is the cause of amenorrhea and infertility.Restoration of reproductive function during embryonic womb is impossible.
- hypoplasia of the uterus 2 degrees .Infantile uterus larger than rudimentary (over 3 cm), but the ratio of its body and cervix remains the same.In some older medical sources such uterus called "English tube" because of the ratio of the cervix and the body (3: 1) as the girl - teenager.Menstrual function is represented by irregular, scanty and painful menstruation.During the inspection revealed signs of sexual and / or general infantilism.Forecast relatively favorable: in some cases, long-term correction of hormonal and metabolic disorders can restore reproductive function.
- uterine hypoplasia Grade 3 .Hypoplastic uterus in length does not exceed 7 - 8 cm, and the ratio of the cervix and the body (3: 1) corresponds anatomically normal.The reason for going to the doctor can be a late onset of menstruation and fertility problems.This lends itself to the degree of hypoplasia of therapy.Sometimes, this degree of hypoplasia of the passes themselves.This can be explained by the fact that in the course of examination of patients with suspected hypoplasia of the uterus may occur overdiagnosis, especially hypoplastic uterus.Dr. overestimates the degree of underdevelopment of the uterus, taking the minimum allowable size of the uterus (or minor deviations from the lower permissible limit) for developmental disorders.
Treatment hypoplastic uterus
from hypoplastic uterus refuse treatment in the case of severe (rudimentary uterus, pronounced sexual infantilism).Determine the prospects for treatment in other cases help hormonal and instrumental (ultrasound, X-ray examination) survey methods.The basis of the therapy is adequate hormonal treatment based on tailor-made schemes.
Most often women with uterine hypoplasia ask the question: is it possible to become pregnant while hypoplastic uterus, and want to hear as much as possible a more precise answer.Meanwhile, the answer to this question is rarely straightforward without proper examination and treatment.If a woman physical health, and uterine size decreased slightly, pregnancy is possible, but pregnancy does not guarantee a favorable outcome.
negative answer to the question, is it possible to become pregnant while hypoplastic uterus sounds in the case of congenital anomalies of genital organs and / or the presence of neuro-metabolic-endocrine disorders in the female body.