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Müllerian anomalies and recurrent miscarriage

Sugiura-Ogasawara, Mayumi; Ozaki, Yasuhiko; Suzumori, Nobuhiro

Current Opinion in Obstetrics and Gynecology: August 2013 - Volume 25 - Issue 4 - p 293–298
doi: 10.1097/GCO.0b013e3283632849
REPRODUCTIVE ENDOCRINOLOGY: Edited by David L. Olive
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Purpose of review To review the prevalence of congenital uterine anomalies and pregnancy outcomes in patients with these anomalies.

Recent findings Women with a history of recurrent miscarriage have been estimated to have a 3.2–10.4% likelihood of having a major uterine anomaly except arcuate uterus. Hysterosalpingography and/or 2D ultrasound can be used as the initial screening tools. The American Fertility Society classification of Müllerian anomalies is the most commonly utilized standardized classification. However, there is still no international consensus to distinguish between septate and bicornuate uteri. A total of 35.1–65.9% of patients with bicornuate or septate uteri give live births after correctional surgery. In regard to the live birth rate in the absence of surgery, it has been reported that 33.3–59.5% of patients with such anomalies had a successful first pregnancy after the examination, as compared to 71.7% of individuals with normal uteri (P = 0.084), with no significant difference in the cumulative live birth rate (78.0 and 85.5%, respectively) between the two groups.

Summary Randomized controlled trials comparing the pregnancy outcomes between cases treated and not treated by surgery among patients with a history of recurrent miscarriage are needed because it is not established whether surgery could improve live birth rate.

Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan

Correspondence to Mayumi Sugiura-Ogasawara, Department of Obstetrics and Gynecology, Nagoya City University, Graduate School of Medical Sciences, Mizuho-ku, Nagoya, 4678601, Japan. Tel: +81 52 853 8241; fax: +81 52 842 2269; e-mail: og.mym@med.nagoya-cu.ac.jp

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins