Ultrasound Diagnosis of Abnormalities in the Development of the Uterus and Vagina with Impaired Menstrual Blood Flow in Girls

Abstract

The objective: to study and analyze the indicators of the diagnostic informativeness of the echographic study of anomalies in the development of the uterus and vagina with impaired outflow of menstrual blood in girls.

Materials and methods. For the study, a group of 37 patients (n=37), from 10 to 19 years old, was selected, who were divided into 2 subgroups: 1 subgroup – patients with doubling of the uterus and vagina without disturbing the outflow of menstrual blood (n=25), 2 subgroup – patients with doubling uterus and vagina with partial aplasia of one vagina (n=12). Most of the subjects – 26 girls (10,3 %) – applied for a referral to clarify the diagnosis, 11 (29,7 %) – without complaints from the genitals for differential diagnosis.

Results. At vaginoscopy at all patients the mucous membrane of pink color with well expressed folding. According to ultrasound of the pelvic organs in 1 subgroup in 17 patients the vagina was divided into 2 parts full, and in 8 – incomplete septum, two uteruses were located, parallel to each other, the contours were smooth, clear, M-echo was determined in both uteruses, two cervix with cervical canals. In subgroup 2, 9 patients showed protrusion of different sizes of one of the walls of the vagina, 2 patients in the lateral, 1 – in the upper lateral zone of the vagina was determined by a punctate hole with an inflammatory roller – fistulous entrance to the second vagina. In all patients from the side of the aplasia of the vagina, the uterine cavity is expanded from 10 to 25 mm, filled with echonegative contents. The reliability of the results of ultrasound scanning of anomalies of genital development is equal: the sensitivity of the method – 84,0 %, specificity – 90,9 %, accuracy – 89,1 %.

Conclusions. Manifestation of malformations of the genitals with impaired outflow of menstrual blood occurs at puberty, as after menarche above the aplastic segment of the genital tract accumulates menstrual blood and tumor formation, accompanied by characteristic clinical manifestations. Diagnosis of this pathology is quite complex, which can lead to errors in determining the nature of the pathological condition and, as a consequence, unwarranted surgery. Thus, the need to further improve the methods of diagnosis and management of patients with doubling of the uterus and vagina with impaired menstrual blood flow remains relevant, which will identify diseases at an earlier age or immediately after the appearance of complaints and symptoms.