Reproductive Outcome of Transcervical Uterine Incision in Unicornuate Uterus

Xia, Enlan; Li, Tin‐Chiu; Choi, S.; Zhou, Qiaozhi

doi:10.4103/0366-6999.198919

Cited by 8 publications

(8 citation statements)

References 34 publications

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“…Currently, no standard treatment methods for patients with a pregnancy complicated by a unicornuate uterus. One study of 31 pregnancy patients suggest transcervical uterine incision in patients with a unicornuate uterus may decrease the risk of first trimester spontaneous abortion and increase the live birth rates 5 . This data is consistent with other improved outcomes after removal of uterine septum resection 6 .…”

Section: Discussionsupporting

confidence: 61%

“…Obstetric complications are common and vary widely in patients with CUA. Depending on the type of anomaly, the potential complications include miscarriage, preterm labor, preterm delivery, premature prelabor rupture of membranes, cervical incompetence fetal demise, malpresentation and pre‐eclampsia 1–5 . In our case, surgical repair of our patient's complex uterine malformation resulted in a unicornuate uterus with a neocervix.…”

Section: Discussionmentioning

confidence: 77%

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Abdominal cerclage in a patient with a neocervix with planned cesarean hysterectomy at delivery

Schaible

Haught

Vozar

et al. 2020

J of Obstet and Gynaecol

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Pregnancies complicated by congenital uterine anomalies (CUA) with a neocervix present a variety of challenges for the obstetrician. Abdominal cerclage can be utilized to help prevent preterm delivery in a patient with a neocervix. A 14‐year‐old female presented with right adnexal pain and was found to have a complex uterine anomaly resembling a noncommunicating unicornuate uterus with a cervix embedded in the rudimentary horn. A neocervix was created during surgical removal of the rudimentary horn. The patient became pregnant at age 24, and a transabdominal cerclage served an important role in the prevention of preterm delivery. Although limited data exists regarding the outcomes for the use of abdominal cerclage after the creation of a neocervix, term delivery is possible with said intervention.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 77%

Abdominal cerclage in a patient with a neocervix with planned cesarean hysterectomy at delivery

Schaible

Haught

Vozar

et al. 2020

J of Obstet and Gynaecol

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“…Transcervical uterine incision appeared to improve the pregnancy outcome in women with unicornuate uterus presenting with infertility or miscarriage. In a research study by Xia et al, 64.5% of patients with a unicornuate uterus conceived after a transcervical uterine incision [9]. First trimester spontaneous abortion occurred in 5% of these patients, while 25% and 55% had preterm and term pregnancies, respectively.…”

Section: Discussionmentioning

confidence: 95%

Term pregnancy not requiring cerclage placement or tocolytic therapy in a patient with a unicornuate uterus and history of myomectomy

Biljic-Erski¹,

Vasiljevic²,

Rakic³

et al. 2019

Clin. Exp. Obstet. Gynecol.

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The authors present the case of a 28-year-old nulliparous woman, who successfully carried a term pregnancy in a unicornuate uterus with a solid non-communicating rudimentary horn, and a history of myomectomy, without cerclage placement or tocolytic therapy. The patient was admitted to the present clinic for uterine fibroids and menorrhagia. The patient underwent laparotomy, during which a myomectomy was performed. Twelve months after the surgery, the patient conceived spontaneously. Routine obstetric ultrasounds revealed normal intrauterine fetal development. Cerclage and tocolytic therapy were not indicated at any stage of the pregnancy. A live female neonate was delivered via cesarean section at 39 weeks' gestation.

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“…Several studies [ 21 , 22 ] previously reported that some surgical techniques were used to expand the hemi-uterus and thus improved women’s pregnancy outcomes. However, the subjects for these procedures had severely malformed uteri and poor reproductive histories.…”

Section: Discussionmentioning

confidence: 99%

Analysis of hemi-uterus pregnancy outcomes in uterine malformations: a retrospective observational study

Qian,

Ding,

Shi

et al. 2023

BMC Pregnancy Childbirth

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Background The association between uterine malformations and adverse pregnancy outcomes is well recognized. However, studies on adverse pregnancy outcomes based on one kind of anatomical commonality between different uterine anomalies have not been reported. This study aimed to investigate pregnancy outcomes in pregnancies with uterine malformations when the pregnancy is confined to a hemi-uterus. Methods A retrospective observational study of 336 women who gave birth at our hospital from 2015 to 2021 was performed. Women (n = 112) with a unicornuate, complete bicornuate, or didelphic uterus were set as the study group, and women (n = 224) with a normal uterus were set as the reference group. Maternal and neonatal outcomes were evaluated and compared between the two groups using Student’s t-test, one-way ANOVA, Chi-squared test, Yates correction for continuity, or Fisher’s exact test. Modified Poisson regression analyses were used to estimate the relationships between the hemi-uterus pregnancy and preterm birth, preterm premature rupture of membranes, and cesarean section rates by adjusting for potential confounders. A P value < 0.05 was considered significant. Results Women in the study group had a higher history of spontaneous abortion (24.1% vs. 10.7%, P = 0.002) and intrauterine fetal death (5.4% vs. 0.4, P = 0.006). Compared with the reference group, the study group had significantly higher rates of assisted reproductive technology (9.4% vs. 2.2%, P = 0.001) and cord-around-the neck (54.5% vs. 29.9%, P = 0.000). Modified Poisson regression analyses showed that the study group was at higher risk for preterm birth (aRR, 6.8; 95% CI 2.7–16.7), preterm premature rupture of membranes (aRR, 14.1; 95% CI 3.2–62.5), malpresentation (aRR, 13.2; 95% CI 6.3–27.7), and cesarean section (aRR, 4.4; 95% CI 3.3–5.7). Conclusion Women with a unicornuate, didelphic, or complete bicornuate uterus are at higher risk for some adverse pregnancy outcomes than those with a normal uterus.

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Reproductive Outcome of Transcervical Uterine Incision in Unicornuate Uterus

Cited by 8 publications

References 34 publications

Abdominal cerclage in a patient with a neocervix with planned cesarean hysterectomy at delivery

Abdominal cerclage in a patient with a neocervix with planned cesarean hysterectomy at delivery

Term pregnancy not requiring cerclage placement or tocolytic therapy in a patient with a unicornuate uterus and history of myomectomy

Analysis of hemi-uterus pregnancy outcomes in uterine malformations: a retrospective observational study

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