Interactive Transcript
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Our next case is a 24-year-old patient
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who was reportedly six weeks pregnant and
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was definitely miscarrying clinically.
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IUP was never confirmed, so they got
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the ultrasound to make sure that she
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didn't have an ectopic pregnancy.
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Her HCG at this point was less than 100,
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so it would not be entirely unsurprising
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if we didn't see anything potentially.
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So this is a transverse cine clip
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of her uterus transvaginal imaging.
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As we scroll through here, we start to
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see two very widely disparate horns.
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And these are very, very widely spaced, right?
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Almost looks more like a didelphys in the
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sense that they are very widely spaced.
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But if you watch the endometrium, right,
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we're looking for how many cervixes are there.
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There is one here.
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So we have one cervix right here.
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So this is just another
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example of a bicornuate uterus.
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So other things to consider when you have a
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bicorneate uterus, you are at risk of IUGR
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because you have two horns that are smaller
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than usual, so they may not expand completely.
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And you're at risk of an early pregnancy
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loss, again, because the horn doesn't
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completely expand or a preterm labor.
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In a lot of ways, they are similar appearance
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to septate, and if it is similar, you have
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to differentiate by the final contour.
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In this case, it was pretty widely disparate,
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looked more like a didelphys uterus, except
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for the fact that there were not two cervices.
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There is one other special case
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that I'm not going to talk about.
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Here's a bicornuate bicalis, and that's where
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it does look like it has two different cervices.
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The differential there, or the distinction
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Between a didelphys and a bicornuate bicalis
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is that they will communicate somewhere,
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meaning that they did fuse somewhere,
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whereas a didelphys doesn't fuse at all.
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They will never meet.
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So, for example, this broke
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out into two cervices.
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It didn't meet right here.
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This would be a bicornea
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bicollis if you had two cervices.
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If you have a vaginal septum, however,
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it may be completely indistinguishable
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and it will be impossible for us
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to tell by imaging which one it is.
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