Study of mullerian anomalies over 5 years in a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20200879Keywords:
Hystero-laparoscopy, Infertility, Mullerian anomalies, SeptateAbstract
Background: Mullerian anomalies-developmental anomalies of the mullerian system might involve the uterus, cervix, fallopian tubes and vagina of which anomalies of the uterus are the most common. They are often regarded as a treatable form of infertility and have a prevalence of 0.5% in the general population. Though most of them remain asymptomatic, they contribute a good proportion of recurrent pregnancy losses, obstetric complications and infertility. Their timely diagnosis, management and evaluation of associated anomalies proves to be necessary.
Methods: A prospective observational study was undertaken at KIMS, Hubli from 2014 to 2018. The study involved those women who were admitted in the department of obstetrics and gynecology at KIMS, Hubli for various reasons and were detected to have a mullerian anomaly. Their mode of presentation, method of detection, associated anomalies were analysed and statistical conclusions drawn from the same.
Results: During the study period of 5 years, a total of 85 cases of mullerian anomalies were detected amounting to an incidence of 0.15%. 35% of them were asymptomatic, infertility (24%) being the next common mode of presentation. Septate/sub-septate uterus was found to have the poorest obstetric outcome. Mullerian anomalies were seen in combination in 14% of the cases and had an association with other anomalies like renal anomalies in 10% of the cases. Surgical correction was done for most of the cases of vaginal septum and septate/sub-septate uterus.
Conclusions: Mullerian anomalies are often regarded as an uncommon but treatable form of infertility. Their timely detection, treatment and watchful obstetric management is in need.
References
Lin PC, Bhatnagar KP, Nettleton GS, Nakajima ST. Female genital anomalies affecting reproduction. Fertil Steril. 2002;78:899-915.
Propst AM, Hill JA. Anatomic factors associated with recurrent pregnancy loss. Semin Reprod Med. 2000;18:341-50.
Guimaraes Filho HA, Mattar R, Pires CR, Araujo E Jr, Moron AF, Nardozza LMM. Comparison of hysterosalpingography, hysterosonography and hysteroscopy in evaluation of the uterine cavity in patients with recurrent pregnancy losses. Arch Gynecol Obstet. 2006;274:284-8.
Commons C. Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License, 2014. Available at: https://www.researchgate.net/figure/American-fertil ity-society-classification-of-uterine-malformations-4_fig4_261916647. Accessed on 23rd February 2019.
Simon C, Martinez L, Pardo F, Tortajada M, Pellicer A. Mu ¨llerian defects in women with normal reproductive outcome. Fertil Steril. 1991;56:1192-3.
Fedele L, Bianchi S. Hysteroscopic metroplasty for septate uterus. Obstet Gynecol Clin North Am. 1995;22:4.
Troiano RN, McCarthy SM. Mu ¨llerian duct anomalies: imaging and clinical issues. Radiol. 2004;233:19-34.
Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiol. 1992;183:795-800.
Homer HA, Li TC, Cooke ID. The septateuterus: are view of management and reproductive outcome. Fertil Steril. 2000;73:1-14.
Rock JA, Schlaff WD. The obstetric consequences of utero vaginal anomalies. Fertil Steril. 1985;43:681.
Golan A, Langer R, Bukovsky I, Caspi E. Congenital anomalies special clinical situations or suspected malformation. Currently,of the mu¨ llerian system. Fertil Steril. 1989;51:747-55.
Gurtcheff SE, Hatasaka H, Lamber P, Empey R, Morris E, Hammoud A. Clinical presentation of Mullerian anomalies in a large population cohort. Fertil Steril. 2008;90(1):S153-4.
