A classification of congenital uterine anomalies predicting pregnancy outcomes.
OBJECTIVE
To evaluate pregnancy outcomes in women with uterine anomalies by applying a method for diagnosing and classifying congenital uterine malformations.


METHODS
Retrospective study.


METHODS
Tertiary care center.


METHODS
Ninety-four women with uterine anomalies who delivered after 22 gestational weeks.


METHODS
Excluding the 14 women with a history of surgery and seven with one endometrial cavity, 73 women with two endometrial cavities were subdivided into those with two external uterine orifices (2-OS subgroup) and those with one external uterine orifice (1-OS subgroup).


METHODS
Pregnancy outcomes, such as preterm birth, abnormal fetal presentation, cesarean delivery and placental abruption.


RESULTS
The 2-OS subgroup comprised women with a didelphic or complete septate uterus who had a significantly higher rate of cesarean delivery (91% vs. 18%, p < 0.001) than the control group (normal uterine morphology; n = 5763). The 1-OS subgroup comprised women with a bicornuate or incomplete septate uterus who had significantly higher rates of preterm birth (27% vs. 5%, p < 0.001) and placental abruption (14% vs. 0.7%, p < 0.001) than the control group.


CONCLUSIONS
Classification of uterine anomalies by the number of uterine endometrial cavities and external uterine orifices is an easy and reliable means of predicting pregnancy outcomes.
Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
Mio
M
Takami
Shigeru
S
Aoki
Kentaro
K
Kurasawa
Mika
M
Okuda
Tsuneo
T
Takahashi
Fumiki
F
Hirahara
D000037:Abruptio Placentae / Q000209:etiology; D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section; D004717:Endometrium / Q000002:abnormalities*; D005260:Female; D006801:Humans; D007746:Labor Presentation; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology; D012189:Retrospective Studies; D014564:Urogenital Abnormalities / Q000145:classification* / Q000150:complications / Q000175:diagnosis; D014599:Uterus / Q000002:abnormalities*
Uterine anomalies; external uterine orifice; pregnancy outcomes; uterine endometrial cavity