This composite educational graphic provides a side-by-side comparison of 3D ultrasound (coronal view) and Hysterosalpingography (HSG) imaging for the classification of Mullerian Duct Anomalies (MDAs) according to American Fertility Society (AFS) criteria. The panel features nine clinical cases (A-I), each illustrating a specific uterine morphology. (A) Normal uterus with a convex fundal contour and triangular cavity. (B) Unicornuate uterus demonstrating a single uterine horn and fallopian tube. (C) Arcuate uterus characterized by a mild fundal indentation. (D-G) Subtypes of septate uterus, ranging from partial to complete septation, where the 3D ultrasound clarifies the external fundal contour (straight or convex) versus the internal division. (H) Bicornuate uterus showing a prominent external fundal cleft and two divergent horns. (I) Uterus didelphys displaying two completely separate uterine bodies. The dual-modality approach highlights how 3D ultrasound assesses both the external serosal contour and internal cavity, while HSG provides high-contrast visualization of the internal lumen and tubal patency.

This clinical photograph captures an intraoperative view during an emergency Lower Segment Cesarean Section (LSCS), demonstrating a unicornuate uterus. The uterus is notably tubular and elongated, exhibiting a characteristic 'banana-shaped' morphology associated with Müllerian duct anomalies. The uterine surface appears erythematous and highly vascularized, typical of gestational changes. The surgical field is established with green sterile drapes, and the uterus is being exteriorized and supported by a surgeon wearing blood-stained sterile gloves. Surgical instruments, including forceps and retractors, are visible within the abdominal incision. This image serves as a significant educational example of a Class II Müllerian duct anomaly (AFS classification), highlighting the anatomical variations encountered during obstetric surgery in patients with congenital uterine malformations.

This composite of three fluoroscopic hysterosalpingography (HSG) images (A, B, and C) demonstrates varying degrees of a septate uterus, classified as American Fertility Society (AFS) Class V Müllerian duct anomalies. Each image shows radiopaque contrast material outlining the uterine cavities and cervical canals. Image A illustrates a partial septum extending from the fundus to the lower internal os, resulting in two separate uterine horns that converge into a single cervical canal. Image B displays a more extensive septum reaching the external os, creating two distinct cervical canals that terminate at a single cervical opening. Image C demonstrates a complete septate uterus, often termed 'pseudodidelphys,' where the septum divides the entire length of the uterus and cervix, resulting in two completely separate uterine cavities and two distinct cervical canals. These images highlight the diagnostic role of HSG in characterizing the length and clinical significance of uterine septa, which is essential for differentiating them from bicornuate uteri and planning potential hysteroscopic resection.

This composite educational material demonstrates Mullerian duct anomalies (MDA). Figure A is an axial T2-weighted MRI scan showing an asymmetrical uterine morphology with heterogeneous signal intensity, indicating a deviated endometrial cavity. Figure B is an axial fat-saturated T1-weighted MRI scan revealing a localized area of high signal intensity (hyperintense) within a rudimentary uterine horn, consistent with methemoglobin from blood degradation products (hematometra). Figure C is a clinical illustration summarizing the findings: a didelphys/unicornuate uterus with an obstructed, non-communicating right horn leading to hematosalpinx. The diagram also correlates this genital anomaly with ipsilateral renal agenesis, a common associated finding in Herlyn-Werner-Wunderlich syndrome or related MDA classifications. This content is designed for medical education regarding diagnostic imaging of congenital female reproductive tract malformations and the importance of screening for associated renal variations.