Outline
• Introduction
• Abnormality of uterus and fallopian tubes
• Learning outcomes
• Exercise
• References
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INTRODUCTION
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A branch of medicine that specializes in the care of women during pregnancy and childbirth and
in the diagnosis and treatment of diseases of the female reproductive organs. It also specializes in
other women's health issues, such as menopause, hormone problems, contraception (birth
control), and infertility.
OB/GYN: A commonly used abbreviation. ... An obstetrician/gynecologist (OB/GYN) is
therefore a physician who both delivers babies and treats diseases of the female reproductive
organs.

Objectives
• The student will be able to Explain
• Abnormality of uterus and fallopian tubes
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The fallopian tubes develop from the unpaired distal ends of the mullerian ducts and extend
outward from the superolateral portion of the uterus.
The fallopian tubes are between 10 and 14 cm long and normally end by curling around the
ovary. Disease may be asymptomatic or may be linked to infertility.
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Congenital anomalies of the fallopian tube include
Aplasia
Atresia
Hypoplasia ( very long or thin)
Accessory horn or ostia and tubal diverticulum
 Complete absence of the fallopian tube
 A number of embryonic cystic remnants.
It may cause infertility or ectopic pregnancy
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The congenital anomaly of the ovaries include congenital absence of ovary and the
development ovarian cyst.
Accessory ovary (division of the original ovary into two) also comes under this condition.
Rarely, supernumerary ovaries may be found in the broad ligament or elsewhere .
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Para ovarian cysts are not actually ovarian, they are usually located alongside
the ovaries or on the fallopian tubes, but they are often hard to distinguish from
the ovarian cysts.
The cyst can grow to be very big and even extend to the upper abdomen. Their
size and systems do not correspond to the hormonal cycle like other ovarian
cysts do.
Para ovarian cysts can tear, bleed, rupture and become infected. It account for
10% to 20% of all adenexal masses and are relatively uncommon in children.
They are more common in women 30-40 years of age.
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Paramesonephric cyst
Hydatid cyst of morgagni
Wolffian cyst
Kobelt cyst
Cyst of the organ of rosenmuller
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The outer end of the wolffian (Gartner’s) duct may be pea sized, cystic and pedunculated,
and attached to the outer end of the vaginal tube.
Gartner’s duct cyst are the remnants of the wolffian duct and they are
rarely seen in adulthood .
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The paramesonephric duct (or mullerian duct) forms the fallopian tube at
about 9 weeks of gestation.
Multiple invaginations near the ostium of the tube become the fimbriae.
Any secondary invegination that does not connect may form a blind sac
and this enlarges to form a Paramesonephric cyst.
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Para ovarian cyst torsion (2%-16%)
Hemorrhage
Rupture
Secondary infection
Neoplastic transformation (2.9%)
Papillary serous cyst adenoma
Endometriod cystadenocarcinoma
Serous cystadenocarcinoma
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Narrow introitus
Septum
Hymen abnormalities
Agenesis
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Narrow introitus condition is revealed after the marriage. The
patient complains about dyspareunia.
Treatment is done by manual stretching under general anaesthesia or by perineoplasty.
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Transverse vaginal septum (TVS) is formed when the tissue between the vaginal plate and
fused mullerian ducts fail to reabsorb.
This anomaly divides the vagina into two segments, reducing its functional length. The most
common locations are the midvagina at rate of 40% and the inferior vagina at a rate of 14%.
The TVS is one of the most rare mullerian duct anomalies, with an appropriate frequency
of one case in 70,000 females.
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Diagnosed in utero during third trimester with transabdominal
sonography.
Abdominal ultrasonography of the pelvis can also detect
hydro/mucocolpos.
MRI should also be performed to make a definitive diagnosis.
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Surgical management of TVS fetus, neonates and infants –
When third trimester ultrasonography finding lead to the diagnosis, early delivery and
drainage of the obstructed vagina and uterus are indicated.
In infant, vaginal septum is usually thin and can corrected without extensive procedures.
Surgical excision of the obstructed septum through a perineal approach.
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Preoperative Evaluation
 History
 Physical Examination
 Routine Investigation
 Preoperative Consent
 Preoperative Teaching
 Physical Preparation
 Preoperative Checklist
 Presurgery Medication
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Initial and ongoing assessment of the patient includes-
Level of consciousness
Vital signs
Oxygen saturation
Skin color and temperature
Comfort
Fluid balance
Dressings and drains
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Ongoing postoperative nursing interventions includes
Managing pain
Appropriate positioning
Encouraging deep breathing and coughing exercise
Promoting leg excise and ambulation
Maintain adequate hydration
Promoting urine elimination
Provide bowel care.
Surgical aseptic technique is used when changing dressing on
surgical wound.
Clinical follow–up
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As the vagina is largely derive from the mullerian ducts, lack of fusion of the two ducts
can lead to the formation of a vaginal duplication.
Lack of absorption of the wall between the two ducts will leave a residual septum,
leading to a ‘double vagina’
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Physical examination.
Gynecologic ultrasonography.
Pelvic MRI or HSG.
Laparoscopy and /or hysteroscopy may be indicated in some patients, the vaginal
development may be affected.
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Surgical intervention depends on the extent of the individual problem with
a didelphic uterus.
With this a uterine septum can be resected in a simple outpatient procedure
that combines laparoscopy and hysteroscopy.
This procedure greatly decreases the rate of miscarriage for women with
this anomaly.
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EXERCISE
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Explain the Abnormality of uterus and fallopian tubes

LEARNING OUTCOMES
BNSG 701 30
The student explain about
Abnormality of uterus and fallopian tubes

Student effective learning outcome
1.Application of concepts of topic & it’s technological application.
2. Critical and innovative thinking skills
3.Life long learning ability
4.Ability to observe and develop sense making , logical skills for abstract concepts.
5.Ability to understand subject related concepts clearly along with contemporary issues
6.Ability to collaborate
7.Ability to be a lifelong learner
BNSG 501 31

REFERENCES
• Sara Howard (2013) Midwifery retrieved April 17, 2014 from www.powershow.com
• CordeliaS.H.(2014) A brief History Of Midwifery in America. Retrieved April 11, 2014 from
wholisticmaternalnewbornhealth.org/professio nal-education/history-of-midwifery
• midwifeinsight.com/articles/a-short-history-of- midwifery/,retrieved April 18,2014.
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5. Abnormalities of fallopian tube, uterus.pptx

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