Malformations occur in nearly 10% of female genital tracts. Known genetic problems cause 20%, about 5% are due to chromosome aberrations, and approximately 10% are due to environmental causes. Multifactorial inheritance (., a combination of environment and genetics) probably accounts for the rest. Anomalies of the vulva and labia are rare. They include bifid clitoris (occurs most frequently with bladder exstrophy), congenital vaginal prolapse, and vulvar duplication (seen with duplication of the urinary and intestinal tracts). Occasionally, one labia is much larger than the other. If therapy is required, surgical excision is easily accomplished. Anomalies of the hymen occur. | THE CERVIX ANOMALIES OF THE FEMALE GENITAL TRACT Malformations occur in nearly 10 offemale genital tracts. Known genetic problems cause 20 about 5 are due to chromosome aberrations and approximately 10 are due to environmental causes. Multifactorial inheritance . a combination of environment and genetics probably accounts for the rest. Anomalies of the vulva and labia are rare. They include bifid clitoris occurs most frequently with bladder exstrophy congenital vaginal prolapse and vulvar duplication seen with duplication of the urinary and intestinal tracts . Occasionally one labia is much larger than the other. If therapy is required surgical excision is easily accomplished. Anomalies of the hymen occur frequently as it is the most variable structure of the genitalia. The variations include imperforate hymen variation of orifice diameter more than one orifice thickening of the membrane or a median ridge between two orifices. The imperforate hymen requires opening or early complications of mucocolpos or hematocolpos will occur. Later complications may include endometriosis and adenomyosis. Vaginal anomalies include transverse and longitudinal vaginal septa. Transverse vaginal septa are discussed on pages p. 531 . Longitudinal vaginal septa are commonly associated with cervical or uterine anomalies or both. A double vagina is found in association with duplication of the cervix. When asymptomatic these defects require no therapy. One of the more common associations of total vaginal agenesis is the Rokitansky sequence p. 532 . Uterine anomalies usually occur as a result of failure of mullerian fusion. The potential defects include subseptate uterus arcuate uterus bicornuate uterus unicornuate uterus rudimentary uterine horn uterus didelphys duplex cervix cervical atresia and septate vagina. The most serious complications of these defects are 597 Copyright 2001 The McGraw-Hill Companies. Click Here for Terms ofUse. BENSON PERNOLL S HANDBOOK OF OBSTETRICS AND .
