🔬 Chapter 591 · Vulvovaginal & Müllerian Anomalies

Nelson Textbook of Pediatrics 22nd Edition — Comprehensive guide to congenital anomalies of the female reproductive tract. Müllerian anomalies affect 6.7% of females. Includes imperforate hymen, vaginal agenesis (MRKH syndrome), septate uterus (most common), bicornuate uterus, didelphys, OHVIRA syndrome. MRI is gold standard for diagnosis. Associated renal anomalies in 30-40%.

🌐 paeds.online — Pakistan's Pediatric Platform

📋 30 Clinical Scenarios — Vulvovaginal & Müllerian Anomalies

📇 High‑Yield Review Cards

🩺 Clinical Presentations: Müllerian Anomalies

Select a presentation for diagnostic approach and management.

📋 Stepwise Approach: Müllerian Anomalies

🔑 Key Principles (Nelson Ch.591)
• Embryology: Müllerian ducts fuse at 10 weeks, septal resorption by 20 weeks. Vaginal plate canalization at 16 weeks.
• Most common anomaly: Septate uterus (55%). Others: arcuate, bicornuate, didelphys, unicornuate.
• Associated anomalies: Renal (30-40%), skeletal (10-15%). Always perform renal ultrasound.
• Imperforate hymen: Presents with primary amenorrhea + cyclic pain. Hymenectomy after thelarche.
• MRKH syndrome: Absent uterus/vagina, normal ovaries, 46,XX. Vaginal dilation first-line.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Vulvovaginal & Müllerian Anomalies