Benjamin Cody Smith MD, Presenter: Nothing to Disclose

Douglas L. Brown MD, Abstract Co-Author: Author with royalties, UpToDate, Inc

Abimbola O. Famuyide MD, Abstract Co-Author: Nothing to Disclose

Rickey Carter PhD, Abstract Co-Author: Nothing to Disclose

Duplicated cervix has been reported to generally indicate uterus didelphys and to occur less frequently with other anomalies, including septate uterus. Our primary purpose is to report the frequency of the different müllerian anomalies of the uterus that occur in patients with a duplicated cervix. Secondarily, we report the frequency of vaginal septa in the same patient population.

An electronic search of our institution’s clinical databases was performed to retrospectively identify patients who had a duplicated cervix recognized between 1995-2010 (using ICD-9 and HICDA codes), and who also had a pelvic MRI performed. Pelvic MRIs were reviewed to classify the type of uterine müllerian anomaly. Presence of vaginal septa was determined by review of pelvic MRIs and of physical exam findings in the medical charts.

64 patients with a duplicated cervix constitute the study group. 32 patients (50%) had septate uterus, 27 patients (42%) had uterus didelphys, and 5 patients (8%) had bicornuate uterus. A longitudinal vaginal septum was present in 21 of 32 patients (66%) with septate uterus, 18 of 27 (67%) with uterus didelphys, and 1 of 5 (20%) with bicornuate uterus. Transverse vaginal septum was present in 1 of 32 (3%) with septate uterus, 19 of 27 (70%) with uterine didelphys, and 1 of 5 (20%) with bicornuate uterus.

Women with a duplicated cervix, even those who also have a longitudinal vaginal septum, do not necessarily have uterus didelphys. Septate uterus, a surgically correctable uterine anomaly, is as common or more common than uterus didelphys, and considerably more common than bicornuate uterus, in women with a duplicated cervix. Our findings should urge the clinician and radiologist to carefully investigate the entire uterine anatomy prior to making a definitive diagnosis in women with a duplicated cervix.

Septate uterus is at least as common as uterus didelphys in women with a duplicated cervix. Misdiagnosis may deny needed surgical treatment to a patient with septate uterus and duplicated cervix.

Smith, B, Brown, D, Famuyide, A, Carter, R, Duplicated Cervix: Don’t Assume Uterus Didelphys.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11002553.html