Pregnancy and Delivery in Women with Uterine Malformations

Abstract

Background. Uterine defects are the most common malformations of the female reproductive system. They can lead to many obstetric complications, e.g. preterm delivery, intrauterine growth restriction, oligohydramnios and operational delivery. Objectives. Our aim was to analyze the impact of different types of uterine defects on pregnancy outcomes. Material and Methods. The study involved 94 pregnant women with different types of uterine defects hospitalized at the Department of Fetal -Maternal Medicine and Gynecology, RIPMMH in Łódź, between 1994 and 2012. The patients were divided into 5 groups on the basis of diagnosed defects: arcuate (n = 6), bicornuate (n = 50), duplex (n = 29), septate (n = 5) and unicornuate uterus (n = 4). In order to avoid correlated data in statistical analysis, our research did not consider the total number of pregnancies and births but the number of patients. The first pregnancy of each patient, if completed after 22-week gestation, was studied and analyzed. Results. Preterm delivery was the most common complication in pregnancy (55 women, 58.5%). The caesarean section was performed in 73 (78%) women. IUGR was diagnosed in 16% of cases. Placental abruption occurred in 13 (14%) and cervical insufficiency in 10 cases (11%), respectively. Prenatal diagnostic showed abnormalities in 12 fetuses (13%). The Apgar score from 0 to 4 points was assigned to 9 newborns (9.6%), 5-7 to 20 children (21.3%) and 8-10 points to 75 cases (69.1%). Normal birth weight (> 2500 g) was determined in 51 newborns (54.3%). Conclusions. Women with uterine defects are subject to an increased risk of complications in pregnancy and delivery, including premature births, low birth weights, births by cesarean section (Adv Clin Exp Med 2015, 24, 5, 873-879).

First Trimester Uterine Rupture: A Case Report and Literature Review

“…Bicornuate uterus is positioned between these two extremes and, being a unification defect, it derives from an abnormal fusion of the ducts. Literature data show that patients with a uterine anomaly have a poor pregnancy outcome, with a tendency to undergo abortion, preterm delivery, or operative birth [87,88]. The higher risk of rupture of anomalous uteri in the first trimester is still unexplained.…”

Pregnancy Outcomes in Women with Incidentally Detected Unicornuate Uteri

“…Consistent with published data, most patients required a cesarean delivery in our cohort, primarily for malpresentation. 6,[8][9][10][11]14,[22][23][24] Previous studies have reported on the increased risk for adverse pregnancy outcomes in women with abnormal uteri. Most of these studies include all congenital uterine anomalies collectively or a cohort of women with varying a priori risk due to obstetrical history.…”

“…In conclusion, in patients without a poor obstetrical history prior to the diagnosis of unicornuate uteri, rates of midtrimester pregnancy loss and spontaneous preterm birth were lower than previously described. 6,14,[22][23][24][25][26]28 When a unicornuate uterus is incidentally detected, women could probably be reassured that the risk of adverse pregnancy outcomes beyond the first-trimester is lower than studies that include ascertainment bias would indicate. However, the rates of placental abnormalities are significantly higher, often necessitating preterm delivery.…”

Comparative analysis of intrauterine device placement or estrogen therapy to patients after hysteroscopic uterine septum resection

“…Uterine malformations are the most common defects of the female reproductive system, occurring with the incidence of about 4% in the general population of women [1]. It is reported that uterine septum, an important type of uterus defects, occurred with the incidence of 24% and constituted a risk of infertility, miscarriage and complications of pregnancy as well as childbirth [2,3]. Abortion rate in patients with uterine septum is as high as 77.4% with only 6-28% of the live birth rate [4,5].…”