Incidence of congenital uterine malformation in fertile female population undergoing laparoscopic tubal ligation at a tertiary care centre, Lucknow, Uttar Pradesh, India: a study of six years

Background: Congenital uterine anomalies are not only uncommon, many are asymptomatic. A uterine malformation is a type of female genital malformation resulting from an abnormal development of the mullerian ducts during embryogenesis. The prevalence of uterine malformation is estimated to be 6.7% in general population.Methods: This study has included 2423 women who attended family planning OPD in KGMU for purpose of laparoscopic tubal ligation along with general and systemic examination. During the laproscopic ligation procedure the observed uterine anomalies were noted and compared to the data available in the existing medical literature.Results: Out of 2423 females included in this study during 2011-2016, 104 (4.29%) females were diagnosed with uterine anomalies. The Commonest uterine anomaly was arcuate uterus which was seen in 77 patients. (3.1%). Uni-cornuate uterus was seen in 19 patients (0.8%) and bi-cornuate uterus was seen in 9 patients (0.3%). 3 out of these were uni-cornuate uterus with rudimentary horn.Conclusions: Though the congenital uterine malformations are frequent findings in infertile patients but few malformations like uni-cornuate uterus, arcuate uterus and bicornuate uterus are although rare but seen in fertile females, showing their lesser impact on pregnancy and its outcome.

A discussion of diagnostic value and diagnostic indicator in distinguishing arcuate uterus from septate uterus by three dimensional sonography / 中华医学超声杂志（电子版）

Objective To discuss the accuracy of three-dimensional (3D) sonography in diagnosing arcuate uterus and septate uterus and propose a quantitative indicator in distinguishing arcuate uterus and septate uterus.Methods Ninety-six patients with suspected congenital uterine malformation underwent 3D sonography to assess uterine anomalies at Obstetrics and Gynecology Hospital of Fudan University from August 2011 to March 2013.Uterine coronal section was reconstructed and measured in onmi view imaging mode of 3D sonography.Then qualitative diagnosis and categorization was done.The results were compared with diagnosis of hysteroscopy,hysteroscopy combined with laparoscope to determine the sensitivity,specificity,positive predictive values,negative predictive values and total accuracy of 3D sonography in diagnosing arcuate uterus,partial and complete septate uterus respectively.The variable was created in coronal section of uterus constructed through 3D imaging mode to differentiate arcuate uterus from septate uterus.Results There were 33 cases (34.4％,33/96) of arcuate uterus,54 cases (56.2％,54/96) of partial septate uterus and 9 cases (9.4％,9/96) of complete uterus in 96 cases diagnosed by 3D sonography.The accuracy of 3D sonography in diagnosing arcuate uterus and septate uterus was 86.5％.We concluded that 3D sonography had 100％ sensitivity,82.9％ specificity,60.6％ positive predictive value and 100％negative predictive value in the diagnosis of arcuate uterus.The sensitivity of 3D sonography for diagnosis of partial septate uterus was 80.6％,the specificity was 100％,the positive predictive value was 100％,and the negative predictive value was 69.1％.The sensitivity,specificity,positive and negative predictive values of 3D sonography for detecting complete septate uterus were all 100％.The ratio of depth of uterine internal indentation and depth from uterine fundus to the top of intemal indentation was more than 50％ for septate uterus,while less than 50％ for most of the arcuate uterus.Conclusions The diagnostic efficiency of 3D sonography in specific uterine malformation is different.The new quantitative indicator maybe helpful in improving the accuracy of 3D sonography in diagnosing arcuate uterus and septate uterus.

Study of Obstetric Outcomes in Congenital Uterine Malformations / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to establish the distribution and obstetric outcomes in women with congenital uterine malformations. METHODS: A review of the medical records from the department of obstetrics and gynecology from January 1995 to June 2004 were diagnosed 79 patients with congenital uterine malformations. All of the cases were divided into groups according to classification of ASRM (American Society for Reproductive Medicine), which is based on the degree of failure of normal development of the female genital tact. The obstetric outcomes were compared between the groups. Statistical processing of the material was carried with Pearson chi square test. RESULTS: 79 patientss with congenital uterine malformations were diagnosed by operation or imaging studies. Symmetric congenital uterine malformations, consisting of bicornuate uterus (45.6%), septate uterus (19.0%), and uterus didelphys (31.6%), were the most common, constituting 96.2% of the malformations. Two patients (2.5%) had unicornuate uterus and one patient (1.3%) had arcuate uterus. No cases of the agenesis type and T-shaped uteri were found. 196 pregnancies occurred in the 74 patients. Only 43.4% of the pregnancies reached term, while 8.2% resulted in preterm delivery, and 48.4% terminated as miscarriages. CONCLUSION: Obstetric complications occur more frequently among women with congenital uterine malformations than among women in general. Knowledge concerning of congenital uterine malformations is important in recognizing and managing the obstetric complications that may result.