title: Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies.
abstract: The clinical implications of congenital uterine anomalies (CUA), and the benefits of hysteroscopic resection of a uterine septum, were evaluated. Studies comparing reproductive and obstetric outcome of patients with and without CUA and of patients who had and had not undergone hysteroscopic resection of a uterine septum, were evaluated. Meta-analysis of studies indicated that the pregnancy rate was decreased in women with CUA (RR 0.85, 95% CI 0.73 to 1.00; marginally significant finding, P = 0.05). The spontaneous abortion rate was increased in women with CUA (RR 1.68, 95% CI 1.31 to 2.15). Preterm delivery rates (RR 2.21, 95% CI 1.59 to 3.08), malpresentation at delivery (RR 4.75, 95% CI 3.29 to 6.84), low birth weight (RR 1.93, 95% CI 1.50 to 2.49) and perinatal mortality rates (RR 2.43, 95% CI 1.34 to 4.42) were significantly higher in women with CUA. Hysteroscopic removal of a septum was associated with a reduced probability of spontaneous abortion (RR 0.37, 95% CI 0.25 to 0.55) compared with untreated women. Presence of CUA might be associated with a detrimental effect on the probability of pregnancy achievement, spontaneous abortion and obstetric outcome. Hysteroscopic removal of a septum may reduce the probability of a spontaneous abortion.
authors.affiliation: First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece; School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, Australia. Electronic address: venetis@gmail.com.
authors.forename: Christos A
authors.initials: CA
authors.lastname: Venetis
authors.affiliation: First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Stamatis P
authors.initials: SP
authors.lastname: Papadopoulos
authors.affiliation: European Academy for Gynecological Surgery, Scientific project on Female Genital Tract Congenital Anomalies, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Rudi
authors.initials: R
authors.lastname: Campo
authors.affiliation: European Society for Gynecological Surgery, Special Interest Group on Reproductive Surgery, Project on Congenital Uterine Anomalies (CONUTA), Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Stephan
authors.initials: S
authors.lastname: Gordts
authors.affiliation: First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Basil C
authors.initials: BC
authors.lastname: Tarlatzis
authors.affiliation: First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece; European Academy for Gynecological Surgery, Scientific project on Female Genital Tract Congenital Anomalies, Diestsevest 43/0001, 3000 Leuven, Belgium.
authors.forename: Grigoris F
authors.initials: GF
authors.lastname: Grimbizis
mesh_terms: D000022:Abortion, Spontaneous / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D015233:Models, Statistical; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000473:pathology; D018570:Risk Assessment; D014564:Urogenital Abnormalities / Q000503:physiopathology* / Q000601:surgery*; D014599:Uterus / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery
keywords: congenital uterine anomaly; miscarriage; obstetric outcome; pregnancy; treatment