Uterus with depression at the fundus is called:

AIIMS BHOPAL NO- 2018( Shift-2nd)

Obstetrics & Gynaecology

Easy

Appeared in: AIIMS BHOPAL NO- 2018( Shift-2nd)

Explanation

An arcuate uterus is characterized by a mild, shallow, and broad indentation or depression at the top of the uterus (fundus).
It is the mildest form of congenital uterine anomaly and results from a near-complete fusion of the Müllerian ducts.
Many clinicians consider it a normal variant because it typically does not affect fertility or pregnancy outcomes significantly.
The key differentiator is the 'mild' nature of the depression, as opposed to the deep cleft seen in a bicornuate uterus.

Option A: Uterus didelphys is incorrect because it represents a complete failure of Müllerian duct fusion, resulting in two separate uterine bodies, two cervices, and often a double vagina. This is a complete duplication, not a simple depression.
Option C: A septate uterus is incorrect because it has a normal external fundal contour (flat or convex). The abnormality is an internal wall of tissue (septum) that divides the uterine cavity, which is a failure of resorption, not fusion.
Option D: A bicornuate uterus is characterized by a deep indentation or cleft at the fundus (typically greater than 1 cm), which gives it a distinct heart shape. The term 'depression' is too mild to accurately describe this more significant anomaly.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Congenital Uterine Malformations (Müllerian Duct Anomalies) as background academic context rather than a clinical decision trigger.
While an arcuate uterus is generally considered benign, other Müllerian anomalies are associated with significant reproductive problems, including recurrent pregnancy loss, preterm labor, fetal malpresentation (e.g., breech), and infertility.
Accurate diagnosis using imaging like 3D ultrasound or MRI is crucial for counseling patients on potential pregnancy risks and determining if surgical correction (e.g., hysteroscopic septum resection for a septate uterus) is necessary.
Nurses should be aware that patients with known uterine anomalies require closer monitoring during pregnancy for complications like preterm labor, cervical insufficiency, and fetal growth restriction.

How to Approach the Question

First, identify the key terms in the question: 'uterus,' 'depression,' and 'fundus.' This points to a question about uterine anatomy.
Recall the different types of congenital uterine anomalies (Müllerian duct anomalies) and their defining features.
Differentiate between the options based on the description. 'Depression' is a general term. Consider the severity of the fundal indentation for each anomaly.
Uterus didelphys (two uteri) and septate uterus (internal wall, normal outside) can be eliminated as they don't primarily describe an external fundal depression.
Compare arcuate and bicornuate uterus. An arcuate uterus has a 'mild' depression, while a bicornuate uterus has a 'deep' cleft. The term 'depression' without further qualification best fits the mildest form.
Select 'Arcuate uterus' as the most precise answer for a simple 'depression at the fundus.'

Concept Tested & Keywords

qwwTEd0L55IsWVRHPI_S_

E6 Obstetrics Williams p. 28-47

E6 Gynecology Williams p. 8-26