Midline uterine defect size is correlated with miscarriage of euploid embryos in recurrent cases.
OBJECTIVE
To compare subsequent pregnancy outcomes after two or more miscarriages in patients with and without congenital uterine anomalies.


METHODS
Case-control study.


METHODS
Nagoya City University Hospital.


METHODS
A total of 42 patients with a bicornuate or septate uterus and 1528 with normal uteri.


METHODS
No surgery.


METHODS
The cumulative success rate for birth, abnormal chromosome karyotype rate in aborted concepti, and the predictive values of the height of the defect/length of the remaining uterine cavity ratio (D/C ratio).


RESULTS
Of the total of 1676 patients, 54 (3.2%) had congenital uterine anomalies; 25 (59.5%) of the 42 patients with a bicornuate or septate uterus had a successful first pregnancy after examination, while this was the case for 1096 (71.7%) of the 1528 with normal uteri. There was no difference in the cumulative live-birth rate (78.0% and 85.5%) within the follow-up period. However, the rates for an abnormal chromosome karyotype in aborted concepti in cases with and without uterine anomalies were 15.4% (two of 13) and 57.5% (134 of 233), respectively, with the latter being significantly higher. The D/C ratio in the miscarriage group was also significantly greater than that for the live-birth group.


CONCLUSIONS
Congenital uterine anomalies have a negative impact on reproductive outcome in couples with recurrent miscarriage and are associated with further miscarriage with a normal embryonic karyotype. The D/C ratio was found to have a predictive value for further miscarriages in recurrent cases.
Sugiura-Ogasawara
Mayumi
M
Department of Obstetrics and Gynecology, Nagoya City University, Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Japan. og.mym@med.nagoya-cu.ac.jp
Ozaki
Yasuhiko
Y
Kitaori
Tamao
T
Kumagai
Kyoko
K
Suzuki
Sadao
S
D037881:Aborted Fetus / Q000378:metabolism / Q000473:pathology; D000026:Abortion, Habitual / Q000209:etiology / Q000473:pathology*; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009929:Organ Size / Q000502:physiology; D010298:Parity; D011003:Ploidies; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D018873:Pregnancy Rate; D014591:Uterine Diseases / Q000150:complications / Q000151:congenital* / Q000453:epidemiology / Q000473:pathology*; D014599:Uterus / Q000002:abnormalities* / Q000473:pathology*