Congenital genital anomalies refer to developmental abnormalities of the female reproductive tract, primarily due to abnormal development, fusion, or canalization of the Müllerian ducts.
Types of Congenital Genital Anomalies
1.
Vaginal Anomalies
- Vaginal Agenesis (Absence of vagina)
- Transverse Vaginal Septum
- Septate Vagina
- Narrow Vaginal Introitus
- Perineal or Vestibular
Anomalies
2.
Uterine Anomalies (Müllerian Duct Malformations)
- Absence of Uterus (Müllerian
Agenesis – Mayer-Rokitansky-Küster-Hauser Syndrome)
- Unilateral Müllerian Duct
Development Failure
- Failure of Recanalization of
Müllerian Ducts
- Uterine Septum
(Complete or Partial)
- Bicornuate
Uterus
- Uterus Didelphys
(Complete lack of fusion of Müllerian ducts)
- T-Shaped Uterus (Due to in
utero exposure to Diethylstilbestrol – DES Syndrome)
3.
Tubal Anomalies
- Accessory Fallopian Tubes
- Atresia or Agenesis of
Fallopian Tubes
4.
Cervical Anomalies
- Cervical Agenesis
- Cervical Hypoplasia
Clinical Features of Congenital Genital Anomalies
- Primary Amenorrhea (Common in vaginal and uterine
agenesis)
- Cyclic Pelvic Pain (Due to obstructed menstrual flow)
- Dyspareunia (Painful
Intercourse)
- Recurrent Miscarriages (In
Uterine Septum, Bicornuate Uterus)
- Infertility
Investigations for Congenital Genital Anomalies
1.
Clinical Examination (Pelvic examination for vaginal or uterine
abnormalities)
2.
Ultrasound (USG) – First-line
imaging
3.
MRI – Gold standard for Müllerian
anomalies
4.
Hysterosalpingography (HSG) –
Evaluates uterine cavity and tubal patency
5.
Laparoscopy & Hysteroscopy –
Confirmatory for uterine and tubal anomalies
Management & Treatment
- Vaginal Agenesis → Neovagina creation via McIndoe Vaginoplasty
- Septate Uterus → Hysteroscopic
Septal Resection
- Bicornuate Uterus → Metroplasty
- Cervical Agenesis → Surgical creation of neocervix (if
possible)
- Obstructive Vaginal
Anomalies → Surgical Correction (Vaginoplasty, Septum Excision)
Keynote Symptoms of Congenital Genital Anomalies
- Absent or underdeveloped uterus and vagina (Müllerian agenesis, Mayer-Rokitansky-Küster-Hauser Syndrome)
- Uterine malformations like bicornuate or septate uterus leading to recurrent miscarriages
- Obstructive anomalies like imperforate hymen or transverse vaginal septum causing cryptomenorrhea
- Ovarian dysfunction leading to primary amenorrhea or infertility
- Pelvic pain, abnormal menstruation, or absent menstruation due to structural defects
1. Calcarea Carbonica
Indications:
- Delayed puberty with
underdeveloped reproductive organs
- Primary amenorrhea in obese,
chilly patients with weak bones
Keynote Symptoms:
- Delayed development of secondary
sexual characteristics.
- Pale complexion, easily fatigued, and
anxious.
- Excessive sweating on the head during
sleep.
- Craving for eggs and indigestible
substances.
- Cold sensitivity and sluggish
metabolism.
2. Natrum Muriaticum
Indications:
- Underdeveloped uterus in
young girls leading to irregular menses
- Hormonal imbalances leading
to infertility due to uterine malformations
Keynote Symptoms:
- Thin, weak girls with delayed puberty.
- Emotionally reserved and avoids
consolation.
- Craving for salty foods and aversion
to fatty foods.
- Irregular menstruation with scanty or
suppressed flow.
- Headaches or migraines accompanying
menstrual issues.
3. Pulsatilla
Indications:
- Delayed or absent
menstruation due to congenital uterine anomalies
- Hormonal imbalances in young
girls with irregular cycles
Keynote Symptoms:
- Menses irregular, delayed, or
completely absent.
- Weeping disposition, desires
consolation.
- Symptoms constantly change, never
fixed.
- Worse in warm rooms, better in open
air.
- Craving for fatty foods but dislikes
warm drinks.
4. Sepia
Indications:
- Congenital uterine anomalies
causing recurrent miscarriages
- Hormonal dysfunction leading
to weak uterine muscles
Keynote Symptoms:
- Sensation of a bearing-down feeling in
the pelvis.
- Indifference to loved ones,
irritability.
- Vaginal dryness with aversion to
intercourse.
- Menses irregular, too early, or too
scanty.
- Better from vigorous exercise and
warmth.
5. Aurum Metallicum
Indications:
- Congenital ovarian dysfunction
leading to primary amenorrhea
- Depression and despair due
to infertility or congenital anomalies
Keynote Symptoms:
- Deep sense of sadness, hopelessness,
and suicidal thoughts.
- Strong sense of failure, especially
related to fertility.
- Menstrual irregularities with absent
or scanty flow.
- Heaviness and pain in the pelvic
region.
- Worse at night, better from warm applications.
