T-Shaped Uterus
Synonyms/Description
T-shaped uterus refers to the imaging appearance of a T rather than a triangular-shaped endometrial cavity
Etiology
Diethylstilbestrol (DES) is a synthetic estrogen that was widely prescribed to pregnant women from the late 1940s until 1970 to prevent miscarriage. An estimated 1 million to 1.5 million women received DES during their pregnancies, and this ultimately affected the reproductive organs of 35% to 69% of their female offspring. The daughters of women treated with DES developed congenital malformations of the uterus, cervix, and vagina as well as adenosis and (rarely) clear cell adenocarcinoma of the vagina. The T-shaped uterus is the most common and characteristic deformity of the uterus resulting from the prenatal exposure to DES and is highly associated with infertility and recurrent miscarriage.
Initially, the term “T-shaped uterus” was reserved for the DES daughters with the characteristic uterine cavity shape. More recently, patients with multiple D&Cs or hysteroscopic procedures can develop endometrial scarring that can be very similar in appearance and outcome to the congenital T-shaped uterus. Sometimes a patient may have recurrent miscarriages and D&Cs with a subsequent diagnosis of T-shaped uterus as a result of Asherman’s syndrome. Whether those patients had a congenital T-shaped uterus or acquired extensive scarring that distorted the endometrial cavity often cannot be determined.
Ultrasound Findings
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