An observational study of effect of Mullerian anomalies on pregnancy

ABSTRACT

Background: Mullerian anomalies occur in approximately 3-4% of fertile and infertile women, 5–10% of women with recurrent early pregnancy loss, and up to 25% of women with late first or second-trimester pregnancy loss or preterm delivery. However, due to low prevalence rate and asymptomatic course of the anomalies, Mullerian anomalies remain underdiagnosed and often overlooked as a possible cause of recurrent pregnancy failures, preterm deliveries, IUGR and low birth weight.Methods: Total of 30 cases of Mullerian anomalies with pregnancy, prior diagnosed or incidental during LSCS, were studied for complications during pregnancy, history of gynecological complaints and rate of diagnosis with routine imaging technique.Results: Septate uterus was the most common anomaly seen in this study (36.6%).56.6% were diagnosed incidentally during LSCS despite the fact 26.6% of cases had history of 2 or more abortions and 30% had some or other gynecological complaints previously. 10% of pregnancies ended in abortions, 20% had preterm delivery, 36.6% had malpresentations and there was case of rupture uterus (03.3%).Conclusions: Mullerian anomalies are often asymptomatic or have subtle gynecological symptoms which are often missed by both patient and gynecologists. It is observed that due to the asymptomatic course of Mullerian anomalies, invasive nature of HSG and lack of 1.5 Tesla MRI at many institutes leads to low rate of diagnosis of Mullerian anomalies. Pregnancy with Mullerian anomalies often have preterm delivery, IUGR and malpresentation, so, require proper counselling and close monitoring during antenatal period.