Embryological Origin of the Uterus
The uterus develops from the fusion of the paired Müllerian ducts (paramesonephric ducts), making option C the correct answer. 1
Embryological Development
The Müllerian ducts are the fundamental structures that give rise to the female reproductive tract:
- The uterus forms around the 10th week of fetal life through fusion of the two paramesonephric (Müllerian) ducts. 1
- The Müllerian ducts contribute to formation of the fallopian tubes, uterus, cervix, and upper vagina. 2
- The Wolffian (mesonephric) ducts regress in female embryos and do not contribute to uterine development in classical embryological theory. 1
Why Other Options Are Incorrect
- Degenerated Müllerian ducts (option A): The Müllerian ducts do not degenerate in females; they actively fuse and differentiate to form reproductive structures. 1
- Degenerated or fused Wolffian ducts (options B and E): The Wolffian ducts regress in female development and do not form the uterus. 1
- Wolffian and Müllerian fusion (option D): These duct systems do not fuse together; the Wolffian ducts regress while Müllerian ducts develop. 1
Clinical Relevance to Müllerian Anomalies
Understanding this embryology is essential because fusion defects or atresia of one or both Müllerian ducts result in uterine anomalies:
- Unicornuate uterus results from failure of one Müllerian duct to develop properly, accounting for 2.4-13% of all Müllerian anomalies. 3
- These anomalies can cause infertility, endometriosis, preterm delivery, and other reproductive complications. 4, 3
Monitoring Fetal Development at 32 Weeks
For your patient at 32 weeks gestation, appropriate monitoring includes:
- Transabdominal ultrasound is the mainstay for evaluation, with estimated fetal weight calculated and documented at each scan from 20 weeks onward. 5
- Gender determination is typically accomplished during the second trimester anatomy scan at 18-22 weeks, though it can be confirmed at 32 weeks. 5
- At 32 weeks, surveillance focuses on fetal growth, amniotic fluid volume, and fetal well-being rather than anatomical survey. 5