Pregnancy Associated With Congenital Abnormalities of the Female Reproductive Tract

Uterine Rupture during a Trial of Labor in a Case with a Unicornuate Uterus and a Previous Cesarean Section

“…Because many cases with uterine anomalies have elective cesarean sections because of their poor obstetrical histories, previous metroplasties, or breech presentation, the details of uterine contraction in cases with uterine anomalies have not yet been clarified. However, the increased incidence of emergency cesarean sections and uterine inertias reported by some authors [15][16][17] might suggest abnormal uterine function in labor in cases of uterine anomaly. The rotation of the uterus carried out for the successful anastomosis of the contralateral tube and the use of oxytocin in this case may have worsened the situation.…”

The Association of Pregnancy-Induced Hypertension and Uterine Malformations

“…We know of no other study that examined this association. Preeclampsia has previously been reported in 13 of 402 [8], 3 of 48 [9] and 12 of 108 [7] women with uterine anomalies. The above studies provided no control group with normal-shaped uterus for comparison.…”

“…The increased risk of tox emia of pregnancy was attributed to the clinical associa tion of uterine and renal congenital malformations [4,5]. Ernst [6] reported a similar increased incidence of tox emia in patients with uterine anomalies, but this was not confirmed in further studies [7][8][9], However, none of these investigations were controlled. Furthermore, the possible impact of uterine anomalies on the frequency of PIH is currently impossible to assess, since the incidence of this congenital defect is unknown [10.…”

Non-Obstructive Müllerian Anomalies

“…50e53 Although studies have shown some increase in spontaneous abortion rates and preterm birth rates in many types of non-obstructive m€ ullerian anomalies (unicornuate, bicornuate, septate, and didelphic uterus), the unrepaired septate and subseptate uteri have been shown to have the poorest comparative rates of reproductive tract performance. (Table 7) 46,47,51,54 The septate and subseptate uteri have consistently been shown to be associated with increased risks of first trimester spontaneous abortion rates, preterm birth, and fetal malpresentation at term. 46,48,56,57 It has been assumed that the increased spontaneous abortion rate is secondary to poor vascularization of the septum and endometrial factors in the septum which causes abnormal placentation and fetal growth.…”

“…Dystocia is thought to contribute to the increased need for cesarean delivery in these women however, the mechanism is unclear. 47,51 Second stage dystocia has also been described in woman delivering with a longitudinal vaginal septum. A longitudinal vaginal septum may not be continuous proximally at the level of the cervix and in those cases the septum may result in dystocia during the second stage of labor.…”