Wednesday, March 14, 2012

My Girly Parts

I'm special. So is Captain.


Everyone is special in their own unique way, right? I'm special internally, and today I feel like telling you more about it.

Let's go back to when I was a developing fetus, shall we? So much happens during those first few months of development, it's mind boggling, so I'll just focus on internal reproductive organs. (Don't worry! This post is rated PG13 and won't gross you out, AND you might learn something.) We all start with two sets of tubes. Between the 6th and 9th weeks of development for a typical girl, the "boy" ducts dissolve, while the "girl" ducts start to develop. The two tubes fuse together vertically, forming the uterus and top 80% of the vaginal canal. Then, the tissue in the middle dissolves, and by the 12th week of development, that little baby girl has a normal looking uterus.

It sounds straight-forward, but think of how many things could go wrong! What if only one tube develops? What if the tubes don't fuse right? What if the cells in the middle don't dissolve? Well, my friends, then we have something called a Mullerian Duct Anomaly.

I got this picture off of radiology.rsna.org
When I was 18 my doctor discovered something suspicious "down there" during my first PAP exam. I was referred to an OB/GYN and she confirmed that I had a vaginal septum. We scheduled an MRI and the findings state that I have a bicornuate uterus (Picture IV) with complete duplication and separation of two uterine halves. The separation extends all the way down and includes a duplication of the cervix. No other abnormalities were found. What does that mean? The good news: I have both kidneys, normal looking ovaries, and aside from being malformed, normal uterine tissue. The really fascinating news: My uterus is divided in HALF and I have TWO CERVICES! (I'm so cool.) I had the vaginal septum surgically removed a few months later, but the rest of my weirdness remains the same.

For a long time, my doctor and I took this to mean that I actually had a uterus didelphys (Picture III). That means that during development, my tubes didn't fuse at all and developed side by side. They're so independent.

It's not a party mask! It's the two halves of my uterus!
Shortly after getting married, I went to a reproductive specialist for a consultation so I would know what I was getting myself into before we started trying to have babies. That doctor did an ultrasound and decided that I have a complete uterine septum (Picture V) rather than a uterus didelphys because he didn't see two separate tops to my uterus. Okay. So, that means that during development, my tubes fused together correctly, but the tissue in between didn't dissolve at all.

Fast forward to February 2010. My beautiful daughter was just delivered by c-section and, while my ob/gyn still had me opened up, she took a little peek at things. She said I had a heart-shaped uterus. "Perfect for Valentine's Day." (Yes, she really said that.) However, that means that I do indeed have two "tops" to my uterus and that the reproductive specialist wasn't right. So, I guess that goes back to implying I have uterus didelphys after all.

I'm so confused.

With Baby #2 I am seeing a new ob/gyn and this doctor stands by the simple reasoning that if I have to cervices I must have a didelphic uterus. Except, that I have read that a duplicated cervix is possible with a septate uterus as well, and my first ob/gyn didn't mention that my uterine halves were completely disconnected while she was physically looking at them. Also, the initial MRI report stated bicornuate, which implies some fusion. This is why I am still confused.

Here's what I do know: I know that my girly parts are split in half. I know that the right side worked well to carry one baby full-term and that Baby #2 is occupying the same space. I know that I have less space to carry a baby, which means I have higher risks of early labor, miscarriage, and babies with low birth weights. I know that none of those problems happened with Emma, so I am hopeful that pregnancy #2 will continue successfully. I know that the limited space means a higher chance of a breech baby, which means delivery via c-section. I know that I can survive one of those again, no problem.

At this point, it doesn't really matter what kind of uterus I have, as long as it does it's job correctly. However, I think I'll pursue further diagnosis once my uterus is no longer occupied. All of this speculation and uncertainty is a little bit annoying. It's my body, and I'd like to really know exactly how special it is.

1 comment:

  1. You are special! Here is to another successful pregnancy!

    ReplyDelete