A classification of congenital uterine anomalies predicting pregnancy outcomes. (23rd May 2014)

• Record Type: Journal Article
• Authors: Takami, Mio; Aoki, Shigeru; Kurasawa, Kentaro; Okuda, Mika; Takahashi, Tsuneo; Hirahara, Fumiki
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 93:Number 7(2014)
• Page Start: 691
• Page End: 697
• Publication Date: 2014-05-23
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12400
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12400-abs-0001"> <title>Abstract</title> <sec id="aogs12400-sec-0001" sec-type="section"> <title>Objective</title> <p>To evaluate pregnancy outcomes in women with uterine anomalies by applying a method for diagnosing and classifying congenital uterine malformations.</p> </sec> <sec id="aogs12400-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective study.</p> </sec> <sec id="aogs12400-sec-0003" sec-type="section"> <title>Setting</title> <p>Tertiary care center.</p> </sec> <sec id="aogs12400-sec-0004" sec-type="section"> <title>Population</title> <p>Ninety‐four women with uterine anomalies who delivered after 22 gestational weeks.</p> </sec> <sec id="aogs12400-sec-0005" sec-type="section"> <title>Methods</title> <p>Excluding the 14 women with a history of surgery and seven with one endometrial cavity, 73 women with two endometrial cavities were subdivided into those with two external uterine orifices (2‐OS subgroup) and those with one external uterine orifice (1‐OS subgroup).</p> </sec> <sec id="aogs12400-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Pregnancy outcomes, such as preterm birth, abnormal fetal presentation, cesarean delivery and placental abruption.</p> </sec> <sec id="aogs12400-sec-0007" sec-type="section"> <title>Results</title> <p>The 2‐OS subgroup comprised women with a didelphic or complete septate uterus who had a significantly higher rate of cesarean delivery (91% vs. 18%, <italic>p < </italic>0.001) than the control group (normal uterine morphology; <italic>n </italic>=<italic> </italic>5763). The 1‐OS subgroup comprised women with a bicornuate or incomplete septate uterus who had significantly higher rates of preterm birth (27% vs. 5%, <italic>p < </italic>0.001) and placental abruption (14% vs. 0.7%, <italic>p </italic>< 0.001) than the control group.</p> </sec> <sec id="aogs12400-sec-0008" sec-type="section"> <title>Conclusions</title> <p>Classification of uterine anomalies by the number of uterine endometrial cavities and external uterine orifices is an easy and reliable means of predicting pregnancy outcomes.</p> </sec> </abstract>