The history of female genital tract malformation classifications and proposal of an updated system†
Open Access
- 4 July 2011
- journal article
- review article
- Published by Oxford University Press (OUP) in Human Reproduction Update
- Vol. 17 (5), 693-705
- https://doi.org/10.1093/humupd/dmr021
Abstract
A correct classification of malformations of the female genital tract is essential to prevent unnecessary and inadequate surgical operations and to compare reproductive results. An ideal classification system should be based on aetiopathogenesis and should suggest the appropriate therapeutic strategy. We conducted a systematic review of relevant articles found in PubMed, Scopus, Scirus and ISI webknowledge, and analysis of historical collections of ‘female genital malformations’ and ‘classifications’. Of 124 full-text articles assessed for eligibility, 64 were included because they contained original general, partial or modified classifications. All the existing classifications were analysed and grouped. The unification of terms and concepts was also analysed. Traditionally, malformations of the female genital tract have been catalogued and classified as Müllerian malformations due to agenesis, lack of fusion, the absence of resorption and lack of posterior development of the Müllerian ducts. The American Fertility Society classification of the late 1980s included seven basic groups of malformations also considering the Müllerian development and the relationship of the malformations to fertility. Other classifications are based on different aspects: functional, defects in vertical fusion, embryological or anatomical (Vagina, Cervix, Uterus, Adnex and Associated Malformation: VCUAM classification). However, an embryological-clinical classification system seems to be the most appropriate. Accepting the need for a new classification system of genitourinary malformations that considers the experience gained from the application of the current classification systems, the aetiopathogenesis and that also suggests the appropriate treatment, we proposed an update of our embryological–clinical classification as a new system with six groups of female genitourinary anomalies.Keywords
This publication has 39 references indexed in Scilit:
- The Cavitated Accessory Uterine MassObstetrics & Gynecology, 2010
- Unilateral renal agenesis and female genital tract pathologiesActa Obstetricia et Gynecologica Scandinavica, 2010
- Congenital malformations of the female genital tract: the need for a new classification systemFertility and Sterility, 2010
- Hereditary renal adysplasia, pulmonary hypoplasia and Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: a case reportOrphanet Journal of Rare Diseases, 2010
- Müllerian anomalies “without a classification”: from the didelphys-unicollis uterus to the bicervical uterus with or without septate vaginaFertility and Sterility, 2009
- The VCUAM (Vagina Cervix Uterus Adnex–associated Malformation) Classification: a new classification for genital malformationsFertility and Sterility, 2005
- The Association of Uterine and Renal AnomaliesObstetrics & Gynecology, 1978
- The Influence of Minor Degrees of Failure of Fusion of the Müllerian Ducts on Pregnancy and LabourBJOG: An International Journal of Obstetrics and Gynaecology, 1945
- The relation of the growing müllerian duct to the wolffian duct and its importance for the genesis of malformationsThe Anatomical Record, 1941
- Duplication of Bladder, Uterus, Vagina and Vulva, with Successive Full Time Pregnancy and Labour in each Uterus.BJOG: An International Journal of Obstetrics and Gynaecology, 1913