Clinical Investigation

The Outcome of Pregnancies in Cases with Uterine Anomalies and Review of Literature

  • Derya Eroglu
  • Mesut Öktem
  • Ibrahim Esinler
  • Filiz Yanik
  • Hulusi Bülent Zeyneloglu

Turk J Obstet Gynecol 2007;4(1):43-46

OBJECTIVE: To evaluate the outcome of pregnancies in cases with uterine anomalies. Design: Retrospective evaluation of the outcomes of pregnancies in cases with uterine anomalies at the Department of Obstetrics and Gynecology, Baskent University, Ankara, between January 2002 and January 2006. Setting: Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara Patients: The outcomes of pregnancies in 8 cases with uterine anomalies were evaluated. Main outcome measures: Perinatal outcome RESULTS: Uterine anomaly was detected in 8 (8/1250, 0.6%) of the cases delivered during this 4-year period. Two cases with uterus didelphys had uneventful antenatal period, and gave birth to healthy newborns by cesarean section with the indications of breech presentation at term. In two of three patients with unicornuate uterus, symmetrical early intrauterine growth restriction developed at the beginning of the third trimester. One of them delivered a viable newborn weighing 2510 g by cesarean section with the indication of breech presentation at 37 weeks of gestation. In the second patient with unicornuate uterus and early intrauterine growth restriction, preterm premature rupture of membranes developed at 31+6 weeks of gestation and premature contractions started at 32+2 weeks. She was delivered by cesarean section due to failure to progress, and gave birth to a viable female weighing 920 g. The third case who had unicornuate uterus had primer infertility, and conceived spontaneously after an diagnostic hysteroscopy. McDonald cervical cerclage was put at 19 weeks of gestation due to incompetent cervix. She gave birth to a viable female weighing 3550 g by cesarean section with the indication of breech presentation at 38+3 weeks of gestation. In one of two cases who had bicornuate uterus, preterm premature rupture of membranes occured at 28+5 weeks of gestation and she gave birth to a viable newborn weighing 1300 g via cesaren section due to fetal distress at 29+5 weeks of gestation. The second patient with bicornuate uterus had uneventful antenatal period, and a healthy baby was delivered by cesarean section at term. One patient with septate uteri had undergone hysteroscopic resection of the uterine septum; antenatal period passed uneventfully and she gave birth to a viable female by vaginal delivery at 38+4 weeks of gestation. CONCLUSIONS: Pregnancies in women with uterine anomalies are associated with recurrent miscarriages, preterm labors and deliveries, intrauterine growth restriction, abnormal fetal presentations, and other complications; however, pregnancy in an abnormal uterus may progress without incident and result in normal labor.

Keywords: perinatal outcome, uterine anomaly.