Mullerian ductal anomalies and its outcome

Abstract

Background: The aim is to study various investigative modalities to diagnose Mullerian anomalies and to evaluate the reproductive outcome that occurs as a result of malformation of genital tract.Methods: A prospective study of reproductive anomalies and its outcome was performed by using data from women with congenital anomalies attended in OPD either with complains or for operative treatment or incidental diagnosis during caesarean section, manual removal of placenta, during laparoscopy or laparotomy at tertiary care center. Total 70 women with different types of congenital anomalies were included in study. Out of them gynecological cases (27) were diagnosed on basis of clinical examination and other diagnostic aids while Mullerian anomalies in obstetric cases (43) were observed and their outcomes were studied.Results: Most common utero-vaginal anomaly seen in present study was septate uterus with 18 (25.7%) cases, followed by bicornuate uterus with 13 (18.6%) cases. Most common presenting symptom is primary amenorrhea 21 (30%) followed by cyclical abdominal pain 11 (15.7). HSG, USG are the primary tools to detect genital tract anomalies. Surgical correction was required in 47.1% patients.Conclusions: Present study shows prevalence of congenital malformation of female reproductive tract is 0.17% at our tertiary care center. Utero-vaginal anomalies are a morphologically diverse group of developmental disorders. Establishing an accurate diagnosis is essential for planning treatment and management strategies. The surgical approach for correction of utero-vaginal anomalies is specific to the type of malformation and may vary in a specific group.

Studying the Reproductive Performance among Women with Congenital Uterine Anomalies. An observational descriptive study at Mansoura University Hospitals

“…[7] and Cahen-Peretz et al 2019. [8] and contrary to the findings published earlier by Vyas et al [9] who reported that the majority of CUAs related to gynecological cases were observed at 19.03 years. This discrepancy could be explained, according to the author's opinion, by the fact that some of the patients involved in our study might deny their pre-marriage complaints or knowledge about the presence of an anomaly and that they discovered this during the course of the management plane for infertility or obstetric complications.…”

prospective study of Feto maternal outcome in pregnancies with reproductive tract anomalies

“…Similarly miscarriages were the common complication in a study conducted by Chan et al A meta-analysis have documented that there was increased relative risk by 2.89 time of first trimester abortions in mullerian anomalies, which is in line with our study findings. The current study reported a very high rate of caesarean section rate of 72.6% and is comparable to study by Raj et al where the caesarean rate was 63.3% as compared to 34.7% in Hua et al This high rate could be due to the reason that most of the anomalies are diagnosed incidentally during the pregnancy in most of the patients 10.…”

Fetomaternal outcome in pregnancies with reproductive tract anomalies

“…The mean age of the participants was 27.2 (5.1) years which is in line with the results of a study conducted by Vyas et al in which the maternal age was more in the age group of 21-25 years. 18 Various other studies across the globe also have reported similar results. 19,20 It could be due to the fact that the desire for pregnancy is higher during this age group and hence the attitude for seeking care for uterine anomalies.…”

“…A study conducted by Hua et al and Vyas et al have shown that cephalic presentation was common and breech accounted for only around 1/4 th of the participants. 18,21 Bicornuate uterus was the most common uterine anomaly (45.2%) followed by arcuateuterus (19.3%) while septate uterus was present in 14.5% of the pregnant women. Surprisingly, these results are in contrast to the available literature where septate uterus followed by bicornuate uterus was believed to be the common uterine anomaly.…”

“…Surprisingly, these results are in contrast to the available literature where septate uterus followed by bicornuate uterus was believed to be the common uterine anomaly. 18,[22][23][24] In contrast, septate uterus is the most commonly associated with obstetrical complications. 25 Some other studies have reported bicornuate uterus followed by septate uterus to be the common uterine anomaly.…”