Uterine hypoplasia
The content of the article:
- Causes and risk factors
- The degree of the disease
- Symptoms
- Diagnostics
- Treatment of uterine hypoplasia
- Possible complications and consequences
- Forecast
- Prevention
Uterine hypoplasia (infantilism, children's uterus, hypoplastic uterus) is a developmental pathology in which the size of the organ does not correspond to the physiological and age norm. This pathology is widespread and can lead to infertility, habitual miscarriage.
Source: sovets.net
In newborn girls, the uterus is located in the abdominal cavity, its length is 3 cm. In this case, the lengths of the cervix and the body of the uterus are related as 3 to 1, and the angle between them is practically not pronounced. The weight of the uterus does not exceed 4 g. After reaching 4-5 years, the uterus descends into the pelvic cavity. Its size and weight are gradually increasing. After the end of puberty, the length of the uterus reaches 4.5 cm, the width is 4.6 cm, and the thickness (anteroposterior size) is 3.4 cm. During pregnancy, the muscle fibers of the organ are stretched and hypertrophied, which leads to a significant increase in both volume and and the size of the fruit container. In the postpartum period, the uterus begins to invade, as a result of which its size and weight decrease, but still remain somewhat larger than before pregnancy.
They say about hypoplasia of the uterus in those cases when by the end of puberty the size of the uterus lags behind normal, but the organ itself is formed correctly. This pathology is often observed simultaneously with hypoplasia of the vagina, ovaries, external genital organs, that is, it is a manifestation of general genital infantilism.
Causes and risk factors
Uterine hypoplasia can occur both at the stage of intrauterine development and form after the birth of a girl. The causes of congenital pathology are:
- genetic diseases and chromosomal abnormalities;
- intrauterine infections (influenza, herpes, cytomegalovirus, toxoplasmosis, rubella);
- exposure to the body of a pregnant woman of occupational hazards, radiation;
- living in an ecologically unfavorable area;
- bad habits (smoking, alcohol abuse, drug use);
- fetoplacental insufficiency, leading to intrauterine growth retardation.
The following factors that have an impact in childhood and during puberty can lead to the acquired form of underdevelopment of the uterus:
- lesions of the hypothalamus or pituitary gland of toxic, infectious, traumatic or tumor genesis;
- chronic severe diseases of the lungs, liver, kidneys, heart;
- endocrine pathologies (thyroid diseases, diabetes mellitus);
- autoimmune diseases;
- dyshormonal disorders caused by ovarian tumors, severe infectious diseases (rubella, mumps);
- ovarian hypoplasia;
- hypovitaminosis conditions;
- lack of weight (irrational mono-diets for weight loss, malnutrition, starvation);
- chronic stress;
- mental disorders (neuroses, depression, psychosis);
- surgical removal of the ovaries or a significant part of them;
- hereditary predisposition;
- mental overload;
- professional sports;
- smoking, alcoholism, drug and substance abuse.
The degree of the disease
Depending on the length of the uterus in an adult woman, three degrees of uterine hypoplasia are distinguished:
- Teenage, or hypoplastic uterus. The length of the uterine cavity, measured by the probe, is 5.5–7 cm. The ratio of the length of the cervix to the body of the uterus is normal.
- Children's, or infantile uterus. When measured with a probe, the length of the uterus is from 3.5 to 5.5 cm. The length of the cervix is related to the length of the body as 3: 1.
Embryonic or rudimentary uterus. Its length does not exceed 3.5 cm. In this case, the length of the cervix significantly exceeds the length of the body of the uterus
Source: simptomer.ru
Symptoms
The main clinical symptom of uterine hypoplasia is menstrual irregularities. With a rudimentary uterus in girls at the age of 15-16, menstruation is absent (primary amenorrhea), or passes in the form of rarely occurring scanty spotting bleeding.
In patients with II and III degrees of uterine hypoplasia, menarche occurs at the age of over 16 years, or does not occur at all. The menstrual cycle is irregular. Menstrual bleeding can be scanty or, conversely, profuse, accompanied by nausea, headache, fainting, severe pain in the lower abdomen. The occurrence of algomenorrhea against the background of uterine hypoplasia is explained by the following factors:
- decreased tissue elasticity against the background of increased blood flow to the body of the uterus on the eve of menstrual bleeding;
- obstructed outflow of menstrual flow from the uterine cavity through a long and narrow cervical canal;
- the underdeveloped myometrium contracts in a discoordinated manner, which causes significant irritation of the nerve endings.
Patients with uterine hypoplasia usually lag behind in physical development. They are characterized by the following external features:
- short stature;
- thinness;
- insufficient development of the mammary glands;
- slight hair growth in the pubis and armpits;
- narrow pelvis.
During the gynecological examination, the following are revealed:
- retraction of the perineum;
- short and narrow vagina;
- long conical cervix;
- the clitoris, uncovered by the labia;
- hyperateflexia (anterior bending of the uterus);
- dense body of the uterus of size that does not correspond to the age norm.
In women of reproductive age, signs of uterine hypoplasia are:
- anorgasmia;
- decreased libido up to its complete absence (sexual coldness, frigidity);
- habitual miscarriage;
- infertility.
Diagnostics
Diagnosis of uterine hypoplasia begins with the collection of anamnesis, general and gynecological examination of the patient. In order to confirm the diagnosis, if necessary, additional research methods are used:
- functional diagnostic tests to detect the absence of ovulation (pupil symptom, basal temperature measurement, cervical mucus tension);
- ultrasound - allows you to determine the position and size of the uterus, the state of the ovaries and fallopian tubes;
- determination of the level of hormones in the blood (corticosteroids, thyroid hormones, luteinizing and follicle-stimulating hormone, progesterone, prolactin, estradiol, testosterone);
- determination of bone age according to X-ray examination of the hand;
- measuring the size of the pelvis;
- hysterosalpingography;
- X-ray of the skull;
- magnetic resonance imaging of the brain;
- diagnostic laparoscopy;
- determination of karyotype and sex chromatin (carried out in difficult diagnostic cases).
Source: simptomer.ru
Treatment of uterine hypoplasia
Treatment of uterine hypoplasia should begin with improving the lifestyle, that is, creating conditions for normal organ function: correcting the diet, normalizing the daily regimen, eliminating unnerving situations, eliminating excessive physical exertion (for example, in girls involved in professional sports).
The main method of drug treatment of uterine hypoplasia is stimulating or hormone replacement therapy, which is given in a cyclic mode with estrogens and progestins. The course usually lasts 3-4 months, if necessary, it can be repeated. In addition, a course of vitamin therapy is prescribed.
Also, in the treatment of uterine hypoplasia, physiotherapeutic methods are widely used to increase blood flow to the uterus and thereby stimulate its development:
- acupuncture (electropuncture);
- galvanic collar according to Shcherbak;
- endonasal electrophoresis with vitamin B 1;
- application of paraffin or ozokerite to the pelvic area;
- electrical stimulation of the nerve endings of the cervix;
- UHF therapy;
- abdominal decompression;
- inductothermy;
- magnetotherapy;
- laser therapy;
- physical therapy classes;
- gynecological massage.
Shown are sanatorium and balneological treatment of uterine hypoplasia (sea bathing, baths with sea water, mud treatment).
Possible complications and consequences
Uterine hypoplasia can lead to the development of numerous complications:
- infertility;
- habitual miscarriage;
- chronic endometritis;
- chronic endocervicitis;
- weakness and discoordination of labor;
- spontaneous miscarriages and premature birth;
- severe early toxicosis;
- obstruction of the fallopian tubes;
- ectopic pregnancy;
- bleeding in the early postpartum period.
Forecast
The prognosis for life is favorable. The possibility of the onset and gestation of pregnancy is determined by the degree of underdevelopment of the fetus. With a mild degree of the disease against the background of hormonal therapy, the size of the uterus quickly returns to normal, so pregnancy usually proceeds normally and ends happily with childbirth.
With II degree of uterine hypoplasia, long-term treatment is required. It allows you to restore the menstrual cycle, reduce the severity of algomenorrhea. However, the prognosis in terms of pregnancy and its successful completion is less favorable.
With hypoplasia of the uterus of the III degree, pregnancy is excluded. If the patient has preserved ovarian function, then in some cases it is possible to carry out in vitro fertilization with the transfer of embryos of a surrogate mother, but a successful outcome of such a pregnancy is not guaranteed.
Prevention
There are no specific measures to prevent uterine hypoplasia. During pregnancy, women are advised to avoid exposure to any factors that can adversely affect the health of her and the fetus (occupational hazards, smoking, alcoholic beverages, certain medications, etc.).
For the correct formation of the uterus, girls, especially in adolescence, need to be provided with proper balanced nutrition. Do not allow adolescent girls to adhere to low-calorie diets, significant physical and mental fatigue. If any infectious or somatic diseases are detected in them, their timely and adequate therapy should be carried out.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
