LESSON PLAN ON UTERINE ABNORMALITY AND

DISPLACEMENT

Name : Miss. Kinjal Vechanbhai Vasava

Subject : Midwifery and obstetric nursing
Topic : uterine abnormality & displacement
Group of participants : 4th B.sc Nursing Students
Date : 09/07/2021
Time : 11:15 AM
Venue : 4 th B.sc Classroom
Evaluator : Mrs.Renuka Prajapati
Method of teaching : lecture cum discussion
Av aids : Power-Point Presentation, Black-board,

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  GENERAL OBJECTIVES:

After attending lecture on uterine abnormality & displacement

participants are able to know about the meaning of uterine abnormality &
displacement l, types of uterine abnormality & displacement and its
important,diagnosis,complication and its management.

 SPECIFIC OBJECTIVES:

After completion of the health talk the participants will be able to:
 Introduction to the topic.
 Define the uterine abnormality & displacement
 Embryological development of uterus
 Incidence, classification
 Types of uterine abnormality & displacement
 Diagnosis
 Clinical feature
 Management
 Complication

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SR TIME SPECIFIC CONTENT TEACHING AV. AIDS EVALUATIO
NO. OBJECTIVE ACTIVITY N
1 1 Introduction For pregnancy and labour to be Lecture cum ppt What is the
minute of the uterine achieved with minimal difficult, discussion meaning of
abnormality a woman must have normal uterine

reproductive anatomy. When abnormality ?

structural abnormality of the

pelvic organ exists, problems
arise that can place an extra
burden on mother & fetus.
2 1 Definition of An uterine malformation is the Lecture cum Ppt Define the
minute uterine result of an abnormal discussion uterine
abnormality development of the mullerian abnormality?

ducts during embryogenesis.

Symptoms ranges from
amenorrhea, infertility,
recurrent pregnancy loss, pain
to normal functioning
depending on the nature of the
defect.

3 2 Embryological  The female genital tract is Lecture cum Ppt what is the

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 minute development of formed in early embryonic life discussion Embryological
uterus when a pair of ducts develops. development of
These mullerian ducts comes uterus?
together in the midline and fuse
into a Y – shaped canal. The
open upper ends of this
structure lead into the
peritoneal cavity and the
unfused portion become the
uterine tube. The fused lower
portion form the uterovaginal
area, which further develops
into the uterus and vagina.

4 1 Incidence  The prevalence of uterine Lecture cum Ppt what is the

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 minute malformation is estimated to be discussion Incidence?
6.7% in general population.
 Slightly higher (7.3%) in the
infertility population
 Significantly higher in a
population of woman with a
history of recurrent miscarriage.

5 2 Classification Lecture cum Ppt Which are the

minute  Class I: Agenesis or hypoplasia discussion classification of
segmental or complete absent uterine

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 uterus abnormality?
 Class II: Unicornute uterus
 Class III: Didelphys uterus also
uterus didelphis
 Class IV: Bicornuate uterus
complete or partial
 Class V: Septate uterus complete
or partial
 Class VI: Arcuate uterus there is
a concave dimple in the uterine
fundus within the cavity.

Class VII: DES- related

abnormalities. The uterine cavity
has a “T-shaped” as a result of fetal
exposure to diethylstilbestrol.
6 1 Explain v Lecture cum Ppt What is Causes
 Failure of development of one
minute Causes of discussion of uterine
or both mullerian ducts: the
uterine abnormality?
absence of both ducts leads to
abnormality.
absence of uterus
 Failure of recanalization of
mullerian ducts: agenesis of the

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 upper vagina or the cervix
 Failure of fusion of mullerian
ducts: in majority the presence
of deformity escapes attention.
In some, the detection is made
accidently during investigation
of infertility or repeated
pregnancy wastages. In other
the D & E operation, manual
removal of placenta during
cesarean section.

7 2 Explain the  ARCUATE (18%) Lecture cum Ppt What is types of

minute types uterine  The cornual parts of the uterus discussion uterine
abnormality remains separated. The uterine abnormality?
fundus looks concave with heart
shaped cavity outline.
 UTERINE DIDELYSH (8%)
 There is complete lack of fusion
of the mullerian ducts with a
double uterus, double cervix and

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 double vagina.
 UTERUS BICORNIS (26%)
 Uterus bicornis bicollis: There
are two uterine cavities with
double cervix with or without
vaginal septum
 Uterus bicornis unicollis:
there are two uterine cavities
with one cervix

 SEPTATE UTERUS (35%)

 The two mullerian ducts are
fused together but there is
persistence of septum in
between the two partially or
completely.
 UNICORNUATE UTERUS OR
UTERUS UNICORNIS (10%)
 There is a failure of
development of one mullerian
duct. Only one side of the
mullerian ducts forms and there
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 is a single uterine cavity with
cervix and one fallopian tube
coming out of the uterus.

 ABSENT UTERUS OR UTERINE

AGENSIS
 This is most severe kind of
uterine malformation. Failure of
uterus, cervix and vagina to
develop.
 DES- RELATED
ABNORMALITY:
 It is due to DES exposure during
intrauterine life. Varites of
malformation are included
 VAGINA: adenosis ( red

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 granular patches)
 FALLOPIAN TUBE: abnormal
fimbrae
 UTERUS: hypoplasia

8 1 Clinical  GYNECOLOGICAL: Lecture cum What are the

minute features  Infertility discussion Ppt clinical
 Dysmenorrhoea features?
 Menorrhagia due to increase
surface area in bicornuate
uterus
 OBSTETRICAL
 Midtrimester abortion
 Increase incidence of
malperentation
 Preterm labour
 Prolonged labour
 Obstruct labour
 PPH

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9 2 Explain  Physical examination Lecture cum Ppt What are the
minute diagnosis of  Ultrasonography discussion diagnosis of
uterine  Pelvic MRI uterine
abnormality.  Hysterosalphinography abnormality?
 Laparoscopy or
hysteroscopy

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10 2 Explain the  TREATMENT Lecture cum Ppt What is the
minute management  Uterine malformations like discussion management of
of uterine absence are not amenable to uterine
abnormality. treatment. abnormality?
 Hypo plastic uterus in young age
girls may gradually develop with
advance of age.
 Oestrogen therapy may be
temporarily given for
amenorrhea, oligomenorrhea:
dilation and curettage may be
helpful in some cases with
dysmenorrhea.
 Surgery of double uterus
 Chances of pregnancy develop in
the Hypo plastic uterus.

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11 2 Explain the  Abortion Lecture cum Ppt What is the
minute complication  Weak uterine action discussion complication of
of uterine  PPH uterine
abnormality.  Adhesion of placenta abnormality?
 Malperesentations
 Prolonged or obstructed labour
 Uterine rapture due to its poor
development
 The uterus has central position in the
12 1 min Explain pelvic. The ternal os is at the level of the
displacement ischial spine.
Ppt
of uterus.  Retroversion of the uterus: it mean that the Lecture cum What is
axis of the cervix become behind the discussion displacement of
vertical axis of female body. uterus?
 Retoflexion: axis of the uterine body
behind the ais of female body.

13 1 Explain the  1st DEGREE: axis of the cervix is behind the Lecture cum Ppt What is the
minute degree of vertical axis of female but the fundus is discussion degree of
uterine above the promontory. uterine

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 displacement.  2nd DEGREE: the fundus is below the displacement?
promontory but still above the external os
 3rd DEGREE: the fundus is below the
external os
 PAIN
14 1 Explain  Low backache
minute symptoms of  Dysmenorrheal
uterine  Mid cyclic pain Lecture cum
Ppt
displacement?  Menstrual disturbance discussion What are the
 SIGNS symptoms of
 Cervix is displaced , A soft, smooth, non uterine
tender mass filling the cul-de-sac displacement?

Absense of uterus

15 1 Explain the  PV examination Lecture cum Ppt What is the

Minute investigation  Hysterography for find out the position of discussion investigation of
of uterine uterus uterine
displacement  Double pessary test displacement?

16 1 Explain

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 Minute complication  Kinking of the uterus vessels, congestion of Lecture cum What is the
Ppt
of uterine uterus- dysmenorrhea, abortion discussion complication of
displacement.  Congestion of the ovary: polymenorrhra, uterine
mid cyclic pain displacement?
 Infertility
 Uterine prolapsed
 Prolepses of tube ovaries

17 2 Explain  Possible therapies for retroversion Lecture cum Ppt  What is the
minute management  Bladder drainage by indwelling catheter discussion management of
of uterine  Patient positioning exercises uterine
displacement  Manipulation of the uterus in to its displacement.
usual anatomic position, with or
without to colysis or anesthesia
 Colonoscopic manipulation of uterine
fundus under
 NURSING MANAGEMENT
 Assess the condition of the women by
collecting health history, menstrual

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 history and obstetrical history.
 Based on the severity of the conditions
plan for interventions.

Educate the couple about best possible

treatment of uterine abnormality &
displacement.

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SUMMARY:
After completion of power point presentation the students are able to
know about:
 Define the uterine abnormality & displacement
 Embryological development of uterus
 Incidence, classification
 Types of uterine abnormality & displacement
 Diagnosis
 Clinical feature
 Management
 Complication

BIBLIOGRAPHY

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1. Basvanthappa B.T: “TEXT BOOK OF MIDWIFERY AND REPRODUCTIVE HEALTH
NURSING” first edition 2006, jaypee brother publication, new delhi. Page no: 200 to
208
2. Dutta D.C: “TEXT BOOK OF OBSTETRICS” 6th edition 2004: page no: 199-192
3. Kumari neelam 2010; 1st edition “MIDWIFERY AND GYNECOLOGICAL NURSING”
s.vikas and company: page no: 160-170
4. Annamma jocob “A COMPREHENSIVE TEXBOOK OF MIDWIFERY AND
GYNECOLOGICAL NURSING” 5th edition.new delhi:jaypee brother medical publisher
ltd pp(456-460).
5. Myles “TEXT BOOK FOR MIDWIVES” fifth edition UK: churchill livingstone elsevier.

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