Hypoplasia of the uterus: the causes of the child’s uterus, asget pregnant

Update: October 2018

The definition of “the child’s uterus in a woman” unites many
terms: hypoplastic uterus, infantile uterus, underdeveloped
uterus. This pathology is currently encountered.
quite often and often accompanied by the difficulties of conception and
pregnancy carrying. The child’s womb in an adult woman can
to be both an independent disease and one of the signs
genital or sexual infantilism.

Characteristic “adult” uterus

The uterus is considered to be the main organ in the female body,
it performs a hormonal function, in its absence impossible
menstruation, and, important moment, pregnancy. During labor the uterus
actively helps the birth of a child, due to
developed muscle layer and its contractions (contractions).

The size of the fruit tree depends on the age
the fair sex. Newborn girl has
the uterus is about 3 cm long, and the cervix is ​​related to the body of the uterus as
3/1. The angle between the neck and the body is not pronounced, and the mass of the uterus is about 4
grams.

In the period of childhood, which lasts up to 8 years and ends
By the start of puberty, the size of the uterus undergo
changes. In the first year of life, its length is 2.5 cm, and weight 2.3
gram. By the age of 4, the weight of the uterus increases to 2.8 grams,
and by the sixth birthday of the girl, the weight of the uterus is equal to its weight at birth.
The ratio of the cervix and uterus also changes: by the end of the first year it is early
2/1, by the fourth anniversary – 1.7 / 1, and at 8 years old – 1.4 / 1. If
the newborn uterus is in the abdominal cavity, then by the age of 4 she
descends into the pelvis.

The size of the uterus of a woman of childbearing age depends on
presence / absence of a history of pregnancies:

  • there were no pregnancies – length 4.5 cm +/- 3 mm, width 4.6 cm
    +/- 4 mm, thickness (anteroposterior size) 3.4 cm +/- 1 mm;
  • there were pregnancies, but they were interrupted (abortions, miscarriages) – length 5.3
    cm +/- 3 mm, width 5.0 cm +/- 5 mm, thickness 3.7 +/- 1 mm;
  • women who have given birth – length 5.8 cm +/- 3 mm, width 5.4 cm
    +/- 6 mm, thickness 4.0 +/- 2 mm.

As soon as a woman becomes pregnant, the uterus begins to grow vigorously
(hypertrophy and stretching of muscle fibers), its length to childbirth
reaches 32 – 33 cm and weighs 1.5 kg. After the baby is born, the organ
undergoes involutive changes and gradually returns to
normal size, but remains somewhat heavier and larger than before
�”Non-pregnant state”.

Normally, the length of the cervix corresponds to about a third of the uterine
length and is 28 – 37 mm. The thickness of the neck reaches 29 – 53 mm.
The shape of the neck also depends on the presence of a history of labor. Have no birth
women are conical, and those who give birth have a cylindrical shape.

Immature uterus and its extent

Uterine hypoplasia is called such a uterus when it is underdeveloped,
that is, by the end of puberty does not reach the size,
corresponding to normal indicators, and the body itself
formed correctly, has a body, bottom, neck and fallopian tubes.
�”Little” womb is often found in conjunction with hypoplasia.
appendages, vagina and external genital organs, that is, it acts
one of the symptoms of genital infantilism.

The degree of uterine underdevelopment:детская матка

  • I degree – the size of the uterus in length, measured by a probe not
    reach 3.5 cm, besides most of the length belongs to the neck –
    such a uterus is called rudimentary or germinal;
  • II degree – measured by probe, the length of the uterus is in
    the boundaries of 3.5 – 5.5 cm, and the proportion of the neck and body is 3/1 –
    this underdevelopment is called infantile or pediatric
    the uterus.
  • Grade III – the length of the uterine cavity on the probe is 5 – 7
    cm and the ratio of the cervix to the uterus in the normal range – 1/3,
    a slight lag in the size of the uterus from the norm is called
    гиполастичной или подростковой the uterus.

Causes of uterine underdevelopment

This disease may be congenital, that is, due to
factors affecting the maternal organism during
gestation, and acquired.

Congenital uterus of small size, one of the pathognomical
signs of genital infantilism, the causes of which
perform:

  • chromosomal abnormalities and genetic diseases;
  • occupational hazards of the mother during gestation;
  • bad habits (smoking and alcohol);
  • placental insufficiency and intrauterine retention
    development;
  • past infections;
  • medication intake.

Acquired uterine hypoplasia develops in the background:

  • disorders of the regulation of the hypothalamic-pituitary system
    (infectious or toxic genesis, trauma);
  • tumor formations of the pituitary, hypothalamus;
  • postponed infections with a severe course;
  • chronic extragenital pathology (heart defects,
    diseases of the kidneys and liver, respiratory organs);
  • endocrine diseases – diabetes mellitus (see symptoms
    diabetes), thyroid disease (read about the symptoms
    thyroid disease);
  • autoimmune processes;
  • dyshormonal disorders after severe childhood
    infections (mumps, rubella) or ovarian cysts and tumors;
  • underdevelopment of the ovaries (in this case, have place hypoplasia
    uterus and ovaries);
  • weight deficit (fasting, malnutrition and malnutrition,
    weight loss diets);
  • hypolivitaminosis;
  • mental disorders (depression, neurosis), stress;
  • ovarian surgery (significant damage to the glandular tissue
    ovary or ovarian removal);
  • toxic factors (drug and alcohol use,
    smoking);
  • excessive exercise, professional
    sports;
  • frequent colds;
  • mental stress;
  • genetic predisposition.

Clinical manifestations

The leading symptom of this pathology is a violation
menstrual cycle. In girls with uterine hypoplasia 1 degree
there is amenorrhea, or extremely rare and scarce bleeding
highlight. With grade 2 and 3, patients complain about
late onset of menstruation (after the 16th anniversary), their
irregularity (long intervals), scanty or, on the contrary,
обильные кровянистые highlight. As a rule, menstruation is very
painful, accompanied by headache, lethargy, nausea and
even fainting. Algomenorrhea is explained by three factors.

  • First, reduced uterine elasticity on the eve of menstruation and
    tide to the organ of the blood reacts pain impulses.
  • Secondly, through the too long and narrow cervical canal
    blood and particles of the uterine mucosa pass with difficulty that
    aggravates and uterine hyperaflexia (uterus bend).
  • Thirdly, the impaired innervation of the body leads to
    discoordinated contractions, which leads to the dispatch of pain
    impulses to the brain and the occurrence of pain.

A general inspection reveals the lag of a girl / girl in
physical development. Patients are generally thin and
fine-boned, not tall, they have a narrow pelvis and shoulders, dairy
glands are underdeveloped, body hair of armpits and pubis
insignificant.

During the examination on the gynecological chair is detected
underdevelopment of the genital lips, perineum retraction, narrow and short
vagina, not covered with sexual lips clit, long and conical
the cervix, while the body of the uterus is small, flattened and
fairly dense, there is a significant bend of the uterus anteriorly
(hyperaflexia).

Mature women complain about the lack of
pregnancies or their spontaneous interruption, more often in early
timing, decrease or complete absence of libido (with rudimentary
uterus), anorgasmia.

Complications

Women with this disease often develop the following
complications:

  • infertility, both primary and secondary (more on the causes
    infertility in women);
  • habitual miscarriage;
  • inflammation of the cervix and uterus (cervicitis and
    endometritis) due to low reproductive stability
    infection systems);
  • complicated course of labor (discoordination and weakness of generic
    forces);
  • severe early toxicosis;
  • preterm delivery;
  • tubal pregnancy (due to crimpiness and lengthening of the fallopias
    pipes);
  • obstruction of the fallopian tubes (read about the treatment of obstruction
    pipes);
  • early postpartum hemorrhage.

Diagnostics

Diagnostics заболевания начинается со сбора жалоб и анамнеза, в
which reveal predisposing uterine underdevelopment diseases and
factors. After a general and gynecological examination and
identifying the characteristic signs of sexual and general infantilism, for
confirming the diagnosis of the “baby uterus” are assigned additional
research methods:

  • functional diagnostics tests (tension
    cervical mucus, rectal temperature measurement, symptom
    �”Pupil”) allow you to define anovulation;
  • ultrasound of the internal genital organs (length and
    the width of the uterus, the length of the cervix, unclosed inner pharynx, long and
    convoluted fallopian tubes, hyperateflexia);
  • determination of hormonal status (testosterone and estradiol,
    prolactin and progesterone, follicle-stimulating and luteinizing
    hormones, thyroid hormones, ketosteroids);
  • measurement of the size of the pelvis
    lag in sexual development);
  • determination of bone age on the radiograph of the hand
    (backlog from biological for 1 – 4 years);
  • hysterosalpingography helps to differentiate grade 2 and 3
    diseases, tortuosity / obstruction of the tubes, long cervical
    channel;
  • magnetic resonance imaging of the brain;
  • X-ray of the skull (condition of the Turkish saddle);
  • if necessary, diagnostic laparoscopy;
  • determination of sex chromatin and karyotype in complex
    cases.

Pathology treatment

Treatment of a disease in adolescents first begins with
correction of nutrition, which should contain the norms of carbohydrates,
protein, fat and is rich in vitamins and trace elements. Special
attention must be paid to the psycho-emotional state of the child
(exclude stress and unnerving situations).

In uterine hypoplasia, hormone therapy is the basis of treatment.
(can be used as a substitute, and stimulating).
Hormonal drugs (estrogens and progestins) are prescribed in
cyclic mode with a break for menstruation courses of 3 – 4
months and with intervals of 3 months. Stimulant treatment
hormones with disease 2 – 3 degrees allows not only
adjust the menstrual cycle, but also increase the size of the uterus.
In case of pathology 1 degree, hormone treatment pursues replacement
a goal that contributes to the recovery cycle.

Also, teenage girls are assigned cyclical courses.
vitamin therapy (groups B, E, A, and C).

Additional treatments

Of the additional methods, in conjunction with the main treatment, widely
use physiotherapy:

  • electroreflexotherapy (acupuncture, electroacupuncture);
  • thiamine endonasal electrophoresis (stimulates activity
    hypothalamus-pituitary, increases the production of FSH and LH);
  • Shcherbak collar;
  • paraffin treatment;
  • ozokeritotherapy;
  • electrostimulation of exocervix receptors;
  • abdominal decompression;
  • UHF-therapy;
  • laser and magnetic therapy;
  • inductothermy.

Effective balneotherapy and spa treatment (treatment
mud baths with sea water and sea bathing). Also
assigned (but not to adolescents) gynecological massage and exercises
physical therapy.

Forecast

Forecast заболевания зависит от степени выраженности патологии и
accurate compliance with the recommendations of the doctor. With the question: “Is it possible
to get pregnant with a child’s uterus “a positive answer will sound only
with 3 and 2 degrees of the disease. Forecast в отношении беременности при
Grade 3 pathology is favorable because the treatment
relatively easily brings the size of the uterus to normal, which
allows you to conceive and endure pregnancy. With 2 degrees of disease
the treatment is long and does not always end in pregnancy or
successful completion of it. Pregnancy with a rudimentary uterus
is impossible.

But in the case of normally functioning ovaries and their production
full eggs (if you can not make a pregnancy)
there is an IVF option followed by gestation
surrogate mother (even with pathology 1 degree).

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