title: Reproductive outcome in uterine malformations with or without an associated unilateral renal agenesis.
abstract: OBJECTIVE
  To analyze reproductive performance in women with genital malformations and to determine whether pregnancy outcomes are influenced by the asrenal agenesis (URA).
  
  
  METHODS
  This was a retrospective study of 174 patients with genitourinary malformations, with available images for reevaluation and classification and a history ofpregnancies. The main outcome measure was the reproductive performance depending on the type of uterine malformation and urinary tract anomalies.
  
  
  RESULTS
  The lowest percentage of women who had only live births occurred in women with bicornuate unicollis uterus (28%). Considering only uterine anomalies that might be associated with URA, those cases had significantly better perinatal outcomes (72% had only living children) than those with no renal agenesis (40%). Of the total number of pregnancies (n=355), patients with URA were associated with term deliveries and living children, whereas women with uterine malformation without URA were more associated with abortions, premature births, and breech presentation.
  
  
  CONCLUSIONS
  Uterine malformations are associated with a high rate of abortions, preterm births, breech presentation, and reproductive losses, but reproductive performance is significantly better for a given type of uterine malformation if it is associated with URA; that is, if the Müllerian anomaly is the consequence of mesonephric or Wolffian anomaly. Different embryological origin for the uterine malformations (mesonephric versus isolated Müllerian anomalies), the absence of 1 renal artery, and previous extrauterine surgery could be related.
authors.affiliation: Service of Obstetrics and Gynecology, San Juan University Hospital. acien@umh.es
authors.forename: Pedro
authors.initials: P
authors.lastname: Acién
authors.affiliation: Service of Obstetrics and Gynecology, San Juan University Hospital.
authors.forename: Maribel
authors.initials: M
authors.lastname: Acién
authors.affiliation: Service of Obstetrics and Gynecology, San Juan University Hospital.
authors.forename: Nerea
authors.initials: N
authors.lastname: Mazaira
authors.affiliation: Service of Obstetrics and Gynecology, San Juan University Hospital.
authors.forename: José A
authors.initials: JA
authors.lastname: Quesada-Rico
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D001946:Breech Presentation / Q000453:epidemiology; D000013:Congenital Abnormalities; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D007674:Kidney Diseases / Q000150:complications / Q000151:congenital*; D009095:Mullerian Ducts / Q000002:abnormalities; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D012098:Reproduction; D012189:Retrospective Studies; D014599:Uterus / Q000002:abnormalities*; D014928:Wolffian Ducts / Q000002:abnormalities