Clinical Study of 37 Women with Uterine Anomalies

Kim, K B; Kwon, Y I; Park, T C; Hwang, J Y; Lee, K H; Ryu, J H; Kim, C J; Kwon, D J; Lee, J W

Abstract

OBJECTIVE
Congenital uterine anomalies are most common of the female reproductive system. The anoamlies are mainly responsible for infertility and obstetric problems, as opposed to other congenital anomalies in the female reproductive system. Clinical evaluation of 37 patients with uterine anomalies was performed to determine the relationship of anomalies to reproductive performance, obstetric risks, and surgical reconstruction (metroplasy) during 8 years. METHOD: Hospital statistics were used to identify patients with Mullerian anomalies who visited outpatient department between Jan. 1990 and Dec. 1997 of Kangnam and Uijongbu St. Mary`s Hospitals. Detail data were obtained by reviewing hospital charts, delivery records, operative reports and radiologic studies.
RESULTS
The incidences of uterine anomalies are 0.25% (1/400 deliveries), and 0.08% (1/1237 outpatients). Symmetrical anomalies constituted of 97.3% of the cases. Most uterine amomalies were diagnosed by means of hysterosalpingogram (37.8%), cesarean section (21.6%) and other operative procedure. Spontaneous abortion (46.9%), preterm delivery (10.2%), term delivery (40.8%), ectopic pregnancy (2.1%) occurred in those patients. The highest incidence of abortions (56.7%) occurred in the group of bicornuate uterus. The incidences of breech presentation and transverse lie were 14% and 2% respectively. Ninety two percent of the deliveries were performed by cesarean section. Of the 11 patients who performed metroplasty, 6 had a living children. For 5 patients with repaired bicornuate uterus, 4 (75%) had a living childern. Two cases of primary infertility was not conceived after metroplasty during over 1 year follow up period.
CONCLUSION
Congenital uterine anomalies are more often associated with spontaneous abortion than infertility. Conventional metroplasty seems to be improving reproductive outcome in women with symmetric uterine anomalies without primary infertility.