Reproductive performance of women with müllerian anomalies

Rackow, Beth W.; Arıcı, Aydın

doi:10.1097/gco.0b013e32814b0649

Cited by 213 publications

(57 citation statements)

References 62 publications

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“…It has been suggested that the endometrium overlying the septum is abnormal or at least suboptimal and this makes it a poor site for implantation (Candiani et al ., 1983; Dabirashrafi et al ., 1995; Fedele et al ., 1996). Therefore, embryos that do implant on the septum are more likely to miscarry as a result of this, possibly because the septum has a disorderly and decreased blood supply, which is insufficient to support subsequent placentation and embryo growth (Candiani et al ., 1983; Raga et al ., 1997; Leible et al ., 1998; Homer et al ., 2000; Kupesic, 2001; Lin, 2004; Rackow and Arici, 2007). These hypotheses remain to be proven and there is evidence to contradict these theories (Pellerito et al ., 1992; Dabirashrafi et al ., 1995; Kupesic, 2001).…”

Section: Discussionmentioning

confidence: 99%

The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review

Chan¹,

Jayaprakasan²,

Zamora³

et al. 2011

Human Reproduction Update

595

372

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BACKGROUNDThe prevalence of congenital uterine anomalies in high-risk women is unclear, as several different diagnostic approaches have been applied to different groups of patients. This review aims to evaluate the prevalence of such anomalies in unselected populations and in women with infertility, including those undergoing IVF treatment, women with a history of miscarriage, women with infertility and recurrent miscarriage combined, and women with a history of preterm delivery.METHODSSearches of MEDLINE, EMBASE, Web of Science and the Cochrane register were performed. Study selection and data extraction were conducted independently by two reviewers. Studies were grouped into those that used ‘optimal’ and ‘suboptimal’ tests for uterine anomalies. Meta-analyses were performed to establish the prevalence of uterine anomalies and their subtypes within the various populations.RESULTSWe identified 94 observational studies comprising 89 861 women. The prevalence of uterine anomalies diagnosed by optimal tests was 5.5% [95% confidence interval (CI), 3.5–8.5] in the unselected population, 8.0% (95% CI, 5.3–12) in infertile women, 13.3% (95% CI, 8.9–20.0) in those with a history of miscarriage and 24.5% (95% CI, 18.3–32.8) in those with miscarriage and infertility. Arcuate uterus is most common in the unselected population (3.9%; 95% CI, 2.1–7.1), and its prevalence is not increased in high-risk groups. In contrast, septate uterus is the most common anomaly in high-risk populations.CONCLUSIONSWomen with a history of miscarriage or miscarriage and infertility have higher prevalence of congenital uterine anomalies compared with the unselected population.

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Section: Discussionmentioning

confidence: 99%

The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review

Chan¹,

Jayaprakasan²,

Zamora³

et al. 2011

Human Reproduction Update

595

372

View full text Add to dashboard Cite

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“…It occurs in approximately 1 out of 76,000 pregnancies. The risk of uterine rupture is 50 to 90%, with most ruptures (approximately 80%) occurring by the end of the second trimester [7]. …”

Section: Introductionmentioning

confidence: 99%

Pregnancy in a unicornuate uterus: a case report

Caserta¹,

Mallozzi²,

Meldolesi

et al. 2014

J Med Case Reports

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IntroductionA unicornuate uterus accounts for 2.4 to 13% of all Müllerian anomalies. A unicornuate uterus with a non-communicating rudimentary horn may be associated with gynecological and obstetric complications such as infertility, endometriosis, hematometra, urinary tract anomalies, abortions, and preterm deliveries. It has a poor reproductive outcome and pregnancy management is still unclear.Case presentationWe report a case of a 26-year-old Caucasian woman presenting with a unicornuate uterus with a non-communicating rudimentary horn. The diagnosis of the anomaly was based on two-dimensional and three-dimensional sonography. The excision of her symptomatic rudimentary horn and her ipsilateral fallopian tube was performed laparoscopically. The growth of the fetus was normal. At 20 weeks’ pregnancy, her cervix started shortening and a tocolytic therapy was started. A cesarean delivery was successfully performed at 39 weeks and 4 days’ gestation.ConclusionsAlthough the reproductive outcome of women with unicornuate uterus is poor, a successful pregnancy is possible. Routine excision of the rudimentary horn should be undertaken during non-pregnant state laparoscopically, and it would be necessary to screen such pregnancies for the development of intrauterine growth retardation with serial ultrasound assessments of the estimated fetal weight and the cervix length.

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“…Thus the cervical collagen concentration has been shown to be lower in women with a history of cervical insufficiency [4,5]. Congenital uterine malformation and surgery on the cervix including conization are other proposed causes of cervical insufficiency [6,7,8,9]. Cerclage treatment has been shown to be of benefit in selected cases of cervical insufficiency [10,11,12].…”

Section: Introductionmentioning

confidence: 99%

Polymorphisms in Genes Coding for Cytokines, Mannose-Binding Lectin, Collagen Metabolism and Thrombophilia in Women with Cervical Insufficiency

Sundtoft

Uldbjerg

Steffensen

et al. 2015

Gynecol Obstet Invest

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Objective: To study the association between cervical insufficiency and single nucleotide polymorphisms in seven genes coding for pro- and anti-inflammatory cytokine-related factors, mannose-binding lectin 2 (MBL2), collagen1α1 (COL1A1), factor II and factor V Leiden genes. Methods: In a case-control study, potential maternal biomarkers for cervical insufficiency were investigated in 30 women with a history of second-trimester miscarriage or preterm birth due to cervical insufficiency and in 70 control women. Results: Homozygous carriers of the interleukin 6 (IL6) -174 genotype GG had an odds ratio (OR) of 3.1 [95% confidence interval (95% CI) 1.3-7.4, p = 0.01] and MBL2 genotypes coding for low or intermediate levels of plasma MBL had an OR of 3.3 (95% CI 1.2-9.0, p = 0.01) for cervical insufficiency compared with controls. Serum MBL levels were lower in women with cervical insufficiency than in controls (median 408 and 1,985 ng/ml, respectively, p < 0.01). Conclusions: Single nucleotide polymorphisms in the IL6 gene and the MBL2 gene and low MBL levels related to the latter polymorphism may increase the risk of preterm birth due to cervical insufficiency.

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Reproductive performance of women with müllerian anomalies

Abstract: Müllerian anomalies, especially uterine anomalies, are associated with both normal and adverse reproductive outcomes, and management in infertile women remains controversial.

Cited by 213 publications

References 62 publications

The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review

The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review

Pregnancy in a unicornuate uterus: a case report

Polymorphisms in Genes Coding for Cytokines, Mannose-Binding Lectin, Collagen Metabolism and Thrombophilia in Women with Cervical Insufficiency

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