{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:22:23Z","timestamp":1790004143630,"version":"4.0.1"},"reference-count":173,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,5,19]],"date-time":"2024-05-19T00:00:00Z","timestamp":1716076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Miguel Hern\u00e1ndez University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Complex urogenital malformations are clinically highly relevant; thus, they must be appropriately diagnosed and classified before initiating treatment. Background\/Objectives: This study aimed to evaluate the applicability and suitability of the embryological\u2013clinical classification of female genital malformations. Methods: A systematic review of cases of genital malformations reported in the literature from 2000 to 2020 was conducted. Case reports and series with the following combinations: \u201cfemale genital tract\u201d AND (malformation OR anomaly OR m\u00fcllerian anomaly OR uterine anomaly OR cervical anomaly OR vaginal anomaly OR cloacal anomaly OR urogenital sinus); and \u201cfemale genital tract\u201d AND (renal agenesis OR ectopic ureter) were searched. A total of 3124 articles were identified, of which 824 cases of genital malformation were extracted. The characteristics of each malformation were included in a database for further analyses. Results: Using the embryological\u2013clinical classification, 89.9% of the published cases and 86.5% of the 52 cases defined as unclassifiable by their authors have been classified in this review. In 73 cases (72.2%), the classification of the malformation using the AFS system was incomplete because although the type of uterine anomaly of the AFS classification matched that of the embryological\u2013clinical classification, characteristics of the urinary system or the vagina were overlooked when using the AFS system. Following a dispersion matrix, we have been able to show that the embryological\u2013clinical classification system is able to classify and subclassify the genitourinary malformations more accurately. Conclusions: The applicability of the embryological\u2013clinical classification has been confirmed after classifying most of the cases of genital malformation previously published. This system also provides a more complete and accurate classification than other classifying systems exclusively based on M\u00fcllerian duct development or uterovaginal parameters, demonstrating its suitability.<\/jats:p>","DOI":"10.3390\/jcm13102988","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T06:31:58Z","timestamp":1716186718000},"page":"2988","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Applicability and Suitability of the Embryological\u2013Clinical Classification of Female Genital Malformations: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8326-679X","authenticated-orcid":false,"given":"Victoria","family":"Navarro","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology Service, Elda University Hospital, 03600 Elda, Alicante, Spain"},{"name":"Reproductive Biopathologies Mixed Research Unit FISABIO-UA-UMH, 03550 San Juan, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6536-453X","authenticated-orcid":false,"given":"Maribel","family":"Aci\u00e9n","sequence":"additional","affiliation":[{"name":"Reproductive Biopathologies Mixed Research Unit FISABIO-UA-UMH, 03550 San Juan, Alicante, Spain"},{"name":"Obstetrics and Gynecology Service, San Juan University Hospital, 03550 San Juan, Alicante, Spain"},{"name":"Division of Gynecology, Miguel Hern\u00e1ndez University, Campus of San Juan, 03550 San Juan, Alicante, Spain"},{"name":"Grant Next Generation EU-EGA Institute for Women\u2019s Health, University College London, London WC1E 6DE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5773-1862","authenticated-orcid":false,"given":"Pedro","family":"Aci\u00e9n","sequence":"additional","affiliation":[{"name":"Division of Gynecology, Miguel Hern\u00e1ndez University, Campus of San Juan, 03550 San Juan, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1093\/oxfordjournals.humrep.a019588","article-title":"Incidence of M\u00fcllerian Defects in Fertile and Infertile Women","volume":"12","year":"1997","journal-title":"Hum. 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