T-shaped uterus

T-shaped uterus is a congenital malformation of the uterus, characterized by a uterine cavity that resembles the shape of the letter "T". This condition is a type of Müllerian duct anomaly (MDA), which refers to a group of congenital uterine anomalies caused by improper development of the Müllerian ducts during fetal life. The T-shaped uterus is particularly associated with in-utero exposure to Diethylstilbestrol (DES), a synthetic estrogen that was prescribed between the 1940s and 1970s to prevent miscarriage and other pregnancy complications. However, it was later found to cause a range of reproductive tract anomalies in the exposed offspring, including the T-shaped uterus.

Causes

The primary cause of a T-shaped uterus is exposure to DES during fetal development. DES exposure can disrupt the normal development of the Müllerian ducts, leading to various structural abnormalities in the reproductive tract of the fetus. Other causes may include genetic factors or other environmental exposures that affect the development of the Müllerian ducts, although these are less well understood.

Symptoms and Diagnosis

Women with a T-shaped uterus may be asymptomatic or may experience a range of reproductive issues, including infertility, recurrent pregnancy loss, preterm labor, and intrauterine growth restriction (IUGR). The diagnosis of a T-shaped uterus is typically made through imaging studies, such as ultrasound, hysterosalpingography (HSG), or magnetic resonance imaging (MRI). These imaging techniques can reveal the characteristic T-shaped appearance of the uterine cavity.

Treatment

Treatment options for a T-shaped uterus depend on the severity of the condition and the patient's reproductive goals. In some cases, surgical intervention may be recommended to reshape the uterine cavity and improve fertility outcomes. This can include hysteroscopic metroplasty, a minimally invasive procedure that aims to normalize the shape of the uterine cavity. Other treatment strategies may focus on managing symptoms or complications associated with the condition, such as the use of assisted reproductive technologies (ART) to achieve pregnancy.

Prognosis

The prognosis for women with a T-shaped uterus varies depending on the extent of the anomaly and the presence of other reproductive tract abnormalities. With appropriate management and treatment, many women with a T-shaped uterus are able to achieve successful pregnancies. However, they may be at increased risk for certain complications, such as preterm delivery and cesarean section.

See Also

• Müllerian duct anomaly
• Diethylstilbestrol
• Hysteroscopic metroplasty
• Assisted reproductive technology