Obstetric outcome in women with congenital uterine malformations.
Ninety-eight cases of congenital uterine malformations were diagnosed with hysterosalpingography (HSG). Symmetric uterine malformations, composed of bicornuate uterus, uterus didelphys and septate uterus, constituted 80% of the cases. Of them, 75% were of the bicornuate type. Infertility (55%) and a suggestion of cervical incompetence (24%) were the main indication for HSG. Premature deliveries (29%), spontaneous first-trimester abortions (24%), ectopic pregnancies (3%), abnormal fetal presentations (23%) and a high cesarean section rate (27.5%) occurred in those patients. The highest rate of first-trimester abortions (47%) and the lowest rate of term deliveries (21%) occurred in the group with T-shaped uteri as compared to a 7% rate of early abortions (P less than .05) and 61% rate of term deliveries (P less than .03) in the unicornuate uterus group. In 30% of the patients with uterine malformations, cervical incompetence was diagnosed. Improved obstetric outcomes occurred in patients treated with cervical cerclage. There was a statistically significant difference between the number of premature deliveries and spontaneous late abortions in the group without cerclage (50%) and that with cerclage (21%) (P less than .001).
Golan
A
A
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
Langer
R
R
Neuman
M
M
Wexler
S
S
Segev
E
E
David
M P
MP
D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology; D000046:Academic Medical Centers; D002585:Cesarean Section / Q000706:statistics & numerical data; D000013:Congenital Abnormalities / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007557:Israel / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology; D011256:Pregnancy Outcome; D014599:Uterus / Q000002:abnormalities*