Adverse obstetric outcomes in congenital Müllerian anomalies: experience from a high-risk pregnancy unit
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20260877Keywords:
Congenital Müllerian anomalies, High-risk pregnancy, Adverse obstetric outcomesAbstract
Background: Congenital Müllerian anomalies are associated with increased risk of adverse obstetric outcomes. Data from Indian centers remain limited, especially from high‑risk obstetric units.
Methods: A 10‑year retrospective record‑based cross‑sectional analysis was conducted at a tertiary care center from August 2011 to July 2021. A total of 53 pregnant women diagnosed with congenital uterine anomalies were included. Outcomes assessed included preterm birth, abortions, PPROM, malpresentation, fetal growth restriction, and placenta accreta spectrum/postpartum hemorrhage..
Results: The most common anomaly was bicornuate uterus (41.5%, n=22), followed by unicornuate uterus (26.3%, n=14), septate/subseptate uterus (15%, n=8), arcuate uterus (15%, n=8), and uterus didelphys (n=1). Preterm birth occurred in 30 women (56.6%), abortion in 13 (24.5%), PPROM in 11 (20.7%), malpresentation in 15 (28.3%), fetal growth restriction in 15 (28.3%), and placenta accreta spectrum and/or postpartum hemorrhage in 10 cases (18.8%).
Conclusions: Congenital Müllerian anomalies substantially increase obstetric risk, particularly preterm birth, PPROM, malpresentation, and hemorrhage. Early identification and risk‑stratified antenatal surveillance are essential in resource‑limited settings.
References
Fox NS, Roman AS, Stern EM, Gerber RS, Saltzman DH, Rebarber A. Type of congenital uterine anomaly and adverse pregnancy outcomes. J Matern Fetal Neonatal Med. 2014;27(9):949-53. DOI: https://doi.org/10.3109/14767058.2013.847082
Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001;7(2):161-74. DOI: https://doi.org/10.1093/humupd/7.2.161
Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update. 2011;17(6):761-71. DOI: https://doi.org/10.1093/humupd/dmr028
Hua M, Odibo AO, Longman RE, Macones GA, Roehl KA, Cahill AG. Congenital uterine anomalies and adverse pregnancy outcomes. Am J Obstet Gynecol. 2011;205(6):558.e1-5. DOI: https://doi.org/10.1016/j.ajog.2011.07.022
Reichman D, Lauger MR, Robinson BK. Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril. 2009;91:1886-94. DOI: https://doi.org/10.1016/j.fertnstert.2008.02.163
Zhang Y, Zhao Y, Qiao J. Obstetric outcome of women with uterine anomalies in China. Chin Med J. 2010;123:418-22.
Nahum GG. Uterine anomalies (How common are they, and what is their distribution among subtypes?). J Reprod Med. 1998;43:877-87.
Woelfer B, Salim R, Banerjee S, Elson J, Regan L, Jurkovic D. Reproductive outcomes in women with congenital uterine anomalies detected by three-dimensional ultrasound screening. Obstet Gynecol. 2001;98(6):1099-103. DOI: https://doi.org/10.1097/00006250-200112000-00019
Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility. 7th edition. Lippincott Williams & Wilkins, Philadelphia. 2005.
Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology. 1992;183(3):795-800. DOI: https://doi.org/10.1148/radiology.183.3.1584936