Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis

Kim, Mina; Kim, Hyo Sun; Kim, Young-Han

doi:10.3390/jcm10214797

Cited by 18 publications

(36 citation statements)

References 64 publications

(41 reference statements)

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“…8,9 The prevalence of genital tract malformations has been reported to vary between 6.0-38%. 9,10 In the general population it was reported to range between 5-7%, 7-8% in the infertile population and 16-25% in the recurrent miscarriage and infertile population. 1,8,11 Malformations involving the uterus have been reported as the most common MDA with septate uterus being the commonest, and didelphys uterus the rarest.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Incidental finding of didelphys uterus in a multigravida woman at Caesarean delivery

Awolude

Olutoye²,

Obajimi³

2022

F1000Res

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Didelphys uterus is one of the rarest Müllerian duct anomalies (MDA) of the female genital tract. Many remain undiagnosed due to possibilities of successful pregnancies and vaginal deliveries in those without or with mild forms of associated cervical and/or vaginal anomalies. Due to this, data on didelphys uterus in pregnancy are rare, with most cases seen during routine ultrasound in pregnancies’ Caesarean section for other obstetric indications. This case was a 36-year-old G4P1+2 female who had successful vaginal delivery in her preceding pregnancy; in index pregnancy, she presented with fetal footling breech in labour and had an emergency caesarean section during which uterine didelphys was diagnosed. Many pregnant women with didelphys uterus will deliver vaginally and, as such, remain undiagnosed. Its presence is one of the possible reasons for persistent abnormal presentations like fetal breech presentation, especially in women with prior successful vaginal deliveries. Early recognition and availability of facilities for management of such incidentally found cases of uterine didelphys will prevent many of the complications associated with pregnancy with them.

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Section: Discussionmentioning

confidence: 99%

Case Report: Incidental finding of didelphys uterus in a multigravida woman at Caesarean delivery

Awolude

Olutoye²,

Obajimi³

2022

F1000Res

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“…[17] Categorizing uterine malformations into canalization defects and uni cation defects can minimize the interference of studies caused by selection bias and insu cient sample size, but the differences in anatomical features between the incomplete bicornuate uterus and other malformations were easily neglected in previous studies. [3] , [4] , [5] In contrast to the complete bicornuate uterus, the severity of the fundal indentation of the incomplete bicornuate uterus is likely directly correlated with pregnancy outcome (Fig. 1).…”

Section: Discussionmentioning

confidence: 99%

“…[20] There was no signi cant difference in the rate of ectopic pregnancy history between the study and reference groups, which was consistent with previous studies. [3] Compared to canalization defects, the effects are more pronounced in late pregnancy in the case of hemiuterus pregnancies. In terms of maintenance of pregnancy, the gestation age at birth was shorter in the study group, even when cases of PTB were excluded (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…According to the American Fertility Association 1988, there are six types of malformations: arcuate, septate, unicornuate, bicornuate uterus, didelphic and T-shaped uterus. [2] Some scholars [3] , [4] , [5] have classi ed these types into uni cation defects (unicornuate, bicornuate, and didelphic uterus) of the Müllerian ducts and canalization defects (septate uterus) due to resorption disorders of the midline septum for the facilitation of research. Arcuate and T-shaped uteri are usually excluded because they are considered minor variants of the normal uteri and thought to have minimal impact on fertility.…”

Section: Introductionmentioning

confidence: 99%

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

Qian

Ding

Shi

et al. 2022

Preprint

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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. The purpose of this study was to investigate pregnancy outcomes in pregnancies with uterine malformations when the pregnancy is confined to a hemi-uterus. Methods:A retrospective observational cohort study of women who gave birth at our hospital from 2015 to 2021 was performed. Pregnancies with a unicornuate, complete bicornuate, or didelphic uterus were set as the study group, and pregnancies with a normal uterus were set as the referencegroup. For each case in the study group, pregnancies with a normal uterus were matched by age (± 2 years) in a 1:2 ratio. Data were obtained by reviewing medical records and telephone interviews. Maternal and neonatal outcomes were evaluated and compared between the two groups. Results: Women in the study group had a higher history of spontaneous abortion and intrauterine fetal death (IUFD). Compared with the reference group, the study group had significantly higher rates of assisted reproductive technology (ART) and cord-around-the neck (CAN). Multivariate logistic regression analyses showed that the study group was at higher risk for preterm birth, preterm premature rupture of membranes (PPROM), malpresentation, and cesarean section. Conclusion: Pregnancies 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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“…Coexisting renal, ureteral, and bladder anomalies are present in up to 40% of these patients [ 2 ]. There is no universally accepted classification system for CUA, but it seems that the classifications from the American Fertility Society (AFS) and from the European Society of Human Reproduction and Embryology/European Society for Gynecological Endoscopy (ESHRE/ESGE) have been the most widely accepted [ 3 ]. The prevalence of CUA in the general population varies from 0.06 to 38%.…”

Section: Introductionmentioning

confidence: 99%

A Successful Pregnancy in a Hemihysterectomized Patient–A Case Report

Domingues

Pinto

2022

Case Reports in Obstetrics and Gynecology

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Introduction. Didelphys uterus, two separate uterine horns or a double uterus with two separate cervices, is one of several congenital uterine anomalies (CUA), accounting for 5% of CUA. CUA could be associated with dysmenorrhea, pelvic pain, and decreased fertility. During pregnancy, it has been associated with higher risk of miscarriage, preterm birth, malpresentation, and fetal growth restriction. There still is insufficient evidence on the efficacy and safety of surgical interventions in CUA, including hemihysterectomy, in what improvement of reproductive performance is concerned. Objective. The aim of the present case report is to review the literature and complement information on pregnancy outcomes after hemihysterectomy, contributing to a better counseling of women planning a pregnancy under these circumstances. Case Presentation. This paper case reports a successful pregnancy in a woman previously submitted to a hemihysterectomy and removal of a vaginal septum by hysteroscopy, due to a symptomatic didelphys uterus. An ipsilateral renal agenesis was also present. A cesarean was performed at 38 weeks’ gestation and a healthy baby was born. Discussion. This paper reports an exceptional clinical situation, with only 9 cases described in the last 6 decades. As in previously reported cases, a cesarean was performed at term, resulting in a live childbirth. In these cases, a higher live birth rate and a lower incidence of preterm deliveries was found, comparing with uterine didelphys pregnancies. Conclusion. Understanding both the exact nature of a uterine anomaly before a surgical treatment and the prognosis for a future pregnancy after the intervention are of paramount importance for precise counseling of future parents.

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Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis

Cited by 18 publications

References 64 publications

Case Report: Incidental finding of didelphys uterus in a multigravida woman at Caesarean delivery

Case Report: Incidental finding of didelphys uterus in a multigravida woman at Caesarean delivery

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

A Successful Pregnancy in a Hemihysterectomized Patient–A Case Report

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