Uterine Anomaly and Recurrent Pregnancy Loss

Abstract

Women with recurrent pregnancy loss have a 3.2 to 6.9% likelihood of having a major uterine anomaly and a 1.0 to 16.9% chance of having an arcuate uterus. Bicornuate and septate uterine have a negative impact on reproductive outcomes and are associated with subsequent euploid miscarriage. The impact of an arcuate uterus on pregnancy outcome remains unclear. There are no definitive criteria to distinguish among the arcuate, septate, and bicornuate uteri. The American Fertility Society classification of Müllerian anomalies is the most common standardized classification of uterine anomalies. According to estimates, 65 to 85% of patients with bicornuate or septate uteri have a successful pregnancy outcome after metroplasty. However, 59.5% of the patients with such anomalies have a successful subsequent pregnancy without surgery, with a cumulative live birthrate of 78.0%. There is no case-control study to compare live birthrates in women who had surgery compared with those who did not. Strict criteria to distinguish between the bicornuate and septate uterus should be established. Further study is needed to confirm the benefits of metroplasty.

Diagnosis and Management of Congenital Uterine Anomalies in Pregnancy

“…[10][11][12][13] In general, the incidence of adverse pregnancy outcomes is higher in patients with minor fusion defects and is further increased in patients with major fusion defects. 11 Interestingly, a retrospective study found that reproductive outcomes were significantly better for a given type of uterine malformation if they were associated with renal agenesis.…”

“…7,10 There are no cohort studies that compare live birth rates in women with a history of pregnancy loss who undergo metroplasty with those who do not. Therefore, further study is needed to confirm the benefits of metroplasty in patients with no obstetric history.…”

“…Therefore, further study is needed to confirm the benefits of metroplasty in patients with no obstetric history. 6,10,47 Predicting and Preventing Preterm Birth Serial transvaginal ultrasounds are standard practice for women with a history of preterm birth secondary to cervical insufficiency. There may be utility in following women with uterine anomalies, but no history of preterm delivery with serial cervical length ultrasound examinations as well.…”

Pregravid preparation for women with a history of miscarriage

“…Анатомические нарушения женских репродуктивных органов вызывают 10-15% случаев невынашивания беременности [18]. Доказано, что хирургические вмеша-тельства по поводу перегородки в матке, внутриматочных синехий, полипов и миом, деформирующих полость матки, значительно улучшают прогноз последующей беременности [19].…”

A méhüreg anatómiai rendellenességei habituális vetélőkben

“…Ezzel össz-hangban áll az, hogy a fejlődési rendellenességből fakadó strukturális eltérések (Müller-cső-anomáliák) arányát 8-10%-ra becsülik [10]. Más megfi gyelések szerint a habituális vetélők között a méhűri rendellenességek aránya csupán 2,2% [11], illetve 6,9% [12].…”