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The Developmental Origin of Cervical and Vaginal Epithelium and Their Clinical Consequences: A Systematic Review

Reich, Olaf MD1; Fritsch, Helga MD2

Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0000000000000023
Basic Science

Objective: Studies on the development of the embryological and fetal development of the cervix and the vagina are rare and mostly go back to the first decades of the last century. The aims of this review were to present the latest knowledge concerning the developmental origin of cervical and vaginal epithelium and to point out new results in the context of different clinical findings.

Materials and Methods: Relevant studies published between 1910 and 2013 were identified via PubMed, MEDLINE, OVID, Web of Science, and EMBASE. The reference lists of retrieved articles were reviewed to locate additional articles. Each abstract was reviewed, and the appropriate publications were obtained and reviewed as well. A total of 33 articles and 8 book chapters were selected for citation in this review.

Results: New objective findings clearly show that human prenatal epithelialization of the cervix and vagina results in 3 morphogenetically determined units: (i) the Müllerian columnar epithelium of the endocervix, (ii) the Müllerian squamous epithelium of the ectocervix and the upper vagina, and (iii) the vaginal squamous epithelium of the lower vagina.

Conclusions: These results are of high clinical relevance and may provide new insight into the histogenesis of ectopy, vaginal adenosis, and the congenital transformation zone. They should be added to the explanations in gynecological, colposcopical, and gynecopathological textbooks.

In Brief

Recent studies may provide new insight into the histogenesis of ectopy, vaginal adenosis, and the congenital transformation zone.

Author Information

1Department of Obstetrics and Gynecology, Medical University of Graz, Graz; and 2Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria

Reprint requests to: Olaf Reich, MD, Department of Obstetrics & Gynecology, Medical University of Graz, Auenbruggerplatz 14, A-8036 Graz, Austria. E-mail:

The authors have declared they have no conflicts of interest.

Copyright © 2014 by the American Society for Colposcopy and Cervical Pathology