title: The association between Mullerian anomalies and short-term pregnancy outcome.
abstract: OBJECTIVE
  To determine the association between Mullerian anomalies (MuAs) and short-term perinatal outcome.
  
  
  METHODS
  A retrospective cohort study, comparing pregnancy outcome in women with and without MuAs matched by age, number of fetuses and parity in a 1:2 ratio.
  
  
  RESULTS
  Among 243 women with MuAs, 156 (64.2%) had bicornuate uterus, 38 (15.6%) had septate uterus, 27 (11.1%) had unicornuate uterus and 22 (9.1%) had didelphic uterus. Compared to controls (n = 486), women with MuAs had higher rates of previous preterm deliveries (PTDs) (20.2 versus 5.9%, p < 0.001) and previous cesarean section (CS) (50.6% versus 12.5%, p < 0.001). Women with MuAs had higher rates of PTDs <37 weeks (25.1% versus 6.1%, p < 0.001) and <32 weeks (4.1% versus 0.6%, p = 0.001), preterm premature rupture of membranes (PPROM) (12.8% versus 2.7%, p < 0.001) and small for gestational age (SGA) infants (12.3 versus 6.8%, p = 0.01). There was higher rate of CS in the MuA group (82.3 versus 22.1%, p < 0.001), mainly due to higher rates of malpresentation and previous CS. In multivariate analysis, MuA was associated with SGA (2.04, 1.15-3.63), PTDs <37 weeks (3.72, 1.79-7.73), PTDs <32 weeks (7.40, 1.54-35.56), PPROM (6.31, 3.04-13.12), malpresentation (21.62, 12.49-37.45) and retained placenta (4.13, 1.73-9.86). No increased risk was observed in the rate of in-labor CS (0.52, 0.21-1.30, p = 0.16). When the rate of adverse outcomes was stratified according to MuAs subtypes, women with unicornuate uterus had the highest rate of breech presentation at delivery (55.6%) and women with didelphy uterine had the highest proportion of PTDs <37 weeks (40.9%).
  
  
  CONCLUSIONS
  Women with MuAs are at increased risk for adverse pregnancy outcome, mainly PTDs + and PPROM, SGA infants and CS due to malpresentation. However, the risk of in-labor CS is not increased compared to the general population.
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petah Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petah Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Effi
authors.initials: E
authors.lastname: Yeoshoua
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petah Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Hadas
authors.initials: H
authors.lastname: Miremberg
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petah Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Krissi
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petah Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petah Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petah Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
mesh_terms: D000328:Adult; D001946:Breech Presentation / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009095:Mullerian Ducts / Q000002:abnormalities*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D014599:Uterus / Q000002:abnormalities
keywords: Cesarean section; Mullerian anomalies; pregnancy outcome; preterm delivery; risk