Book contents
- Gynaecology for the Obstetrician
- Gynaecology for the Obstetrician
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- Chapter 1 Ovarian Cysts in Pregnancy
- Chapter 2 Fibroids in Pregnancy
- Chapter 3 Cervical Abnormalities in Pregnancy
- Chapter 4 Vulval Disorders in Pregnancy
- Chapter 5 Congenital Uterine Malformations and Vaginal Anomalies
- Chapter 6 Vaginal Prolapse and Previous Prolapse Surgery
- Chapter 7 Urinary Tract Problems in Pregnancy
- Chapter 8 Previous Third and Fourth Degree Tears
- Chapter 9 Management of Post-Partum Retained Placental Remnants
- Chapter 10 Gestational Trophoblastic Disease (GTD)
- Chapter 11 Female Genital Mutilation
- Chapter 12 Ovarian and Cervical Malignancy in Pregnancy
- Chapter 13 Post-Partum Contraception
- Chapter 14 Pregnancy Associated Breast Cancer
- Index
- References
Chapter 5 - Congenital Uterine Malformations and Vaginal Anomalies
Published online by Cambridge University Press: 14 July 2023
Book contents
- Gynaecology for the Obstetrician
- Gynaecology for the Obstetrician
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- Chapter 1 Ovarian Cysts in Pregnancy
- Chapter 2 Fibroids in Pregnancy
- Chapter 3 Cervical Abnormalities in Pregnancy
- Chapter 4 Vulval Disorders in Pregnancy
- Chapter 5 Congenital Uterine Malformations and Vaginal Anomalies
- Chapter 6 Vaginal Prolapse and Previous Prolapse Surgery
- Chapter 7 Urinary Tract Problems in Pregnancy
- Chapter 8 Previous Third and Fourth Degree Tears
- Chapter 9 Management of Post-Partum Retained Placental Remnants
- Chapter 10 Gestational Trophoblastic Disease (GTD)
- Chapter 11 Female Genital Mutilation
- Chapter 12 Ovarian and Cervical Malignancy in Pregnancy
- Chapter 13 Post-Partum Contraception
- Chapter 14 Pregnancy Associated Breast Cancer
- Index
- References
Summary
Congenital uterine anomalies (CUAs) are deviations from normal anatomy that result from embryological maldevelopment of the Müllerian ducts. Most are asymptomatic and remain undiagnosed or are diagnosed and treated in adolescence. Some congenital malformations have been linked with adverse pregnancy outcomes such as recurrent miscarriages, infertility, preterm labour and malpresentation. Antenatally, some CUAs may indicate the use of cervical length scanning or growth scans. Intrapartum care for women with CUAs is comparable to the general population but there may be an increased risk of Caesarean section and other complications including vaginal dystocia and lacerations. Women who have been diagnosed with a CUA during pregnancy or parturition need to have additional investigations and treatment tailored to their individual anomaly post-natally.
- Type
- Chapter
- Information
- Gynaecology for the Obstetrician , pp. 40 - 49Publisher: Cambridge University PressPrint publication year: 2023
References
Akhtar, M. A., Saravelos, S. H., Li, T. C. and Jayaprakasan, K. (on behalf of the Royal College of Obstetricians and Gynaecologists). Reproductive implications and management of congenital uterine anomalies. Scientific Impact Paper No. 62. British Journal of Obstetrics and Gynaecology, 127 (2020), e1–e13.Google ScholarPubMed
Chan, Y. Y., Jayaprakasan, K., Zamora, J., et al. The prevalence of congenital uterine anomalies in unselected and high-risk populations: A systematic review. Human Reproduction Update, 17 (2011),761–71.Google Scholar
American Fertility Society. The AFS classification of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Müllerian anomalies and intrauterine adhesions. Fertility and Sterility, 49 (1988), 944–55.Google Scholar
Grimbizis, G. F., Gordts, S., Di Spiezio Sardo, A., et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Human Reproduction, 28 (2013), 2032–44.CrossRefGoogle ScholarPubMed
Saravelos, S. H., Cocksedge, K. A. and Li, T. C.. Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: A critical appraisal. Human Reproduction Update, 14 (2008), 415–29.Google Scholar
Marcal, L., Nothaft, M. A., Coelho, F., Volpato, R. and Iyer, R.. Müllerian duct anomalies: MR imaging. Abdominal Imaging, 36 (2011), 756–64.Google Scholar
Jayaprakasan, K., Chan, Y. Y., Sur, S., et al. Prevalence of uterine anomalies and their impact on early pregnancy in women conceiving after assisted reproduction treatment. Ultrasound in Obstetrics & Gynecology, 37 (2011), 727–32.CrossRefGoogle ScholarPubMed
Grimbizis, G. F., Di Spiezio Sardo, A., Saravelos, S. H., et al. The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies. Human Reproduction, 31 (2016), 2–7.CrossRefGoogle ScholarPubMed
Practice Committee of the American Society for Reproductive Medicine. Uterine septum: A guideline. Fertility and Sterility, 106 (2016), 530–40.Google Scholar
Ludwin, A., Martins, W. P., Nastri, C. O., et al. Congenital Uterine Malformation by Experts (CUME): Better criteria for distinguishing between normal/arcuate and septate uterus? Ultrasound in Obstetrics & Gynecology, 51 (2018), 101–9.CrossRefGoogle ScholarPubMed
Knez, J., Saridogan, E., Van Den Bosch, T., et al. ESHRE/ESGE female genital tract anomalies classification system—the potential impact of discarding arcuate uterus on clinical practice. Human Reproduction, 33 (2018), 600–6.Google Scholar
Rackow, B. W. and Arici, A.. Reproductive performance of women with Müllerian anomalies. Current Opinion in Obstetrics and Gynecology, 19 (2007), 229–37.CrossRefGoogle ScholarPubMed
Chan, Y. Y., Jayaprakasan, K., Tan, A., et al. Reproductive outcomes in women with congenital uterine anomalies: A systematic review. Ultrasound in Obstetrics and Gynecology, 38 (2011), 371–82.Google ScholarPubMed
Venetis, C. A., Papadopoulos, S. P., Campo, R., et al. Clinical implications of congenital uterine anomalies: A meta-analysis of comparative studies. Reproductive BioMedicine Online, 29 (2014), 665–83.Google Scholar
Rikken, J. F. W., Kowalik, C. R., Emanuel, M. H., et al. Septum resection for women of reproductive age with a septate uterus. Cochrane Database of Systematic Reviews, 1 (2017), Art. No.:CD008576.Google ScholarPubMed
National Institute for Health and Care Excellence. Hysteroscopic Metroplasty of a Uterine Septum for Recurrent Miscarriage. NICE Interventional Procedures Guidance 510. (London: NICE, 2015).Google Scholar
National Institute for Health and Care Excellence. Hysteroscopic Metroplasty of a Uterine Septum for Primary Infertility. NICE Interventional Procedures Guidance 509. (London: NICE, 2015).Google Scholar
Heinonen, P. K.. Distribution of female genital tract anomalies in two classifications. European Journal of Obstetrics & Gynecology and Reproductive Biology, 206 (2016), 141–6.CrossRefGoogle ScholarPubMed
Fox, N. S., Roman, A. S., Stern, E. M., et al. Type of congenital uterine anomaly and adverse pregnancy outcomes. Journal of Maternal-Fetal and Neonatal Medicine, 27 (2014), 949–53.Google Scholar
Nahum, G. G.. Rudimentary uterine horn pregnancy. The 20th century worldwide experience of 588 cases. Journal of Reproductive Medicine, 47 (2002), 151–63.Google Scholar
Rock, J. A., Zacur, H. A., Dlugi AM, A. M., et al. Pregnancy success following surgical correction of imperforate hymen and complete transverse vaginal septum. Obstetrics & Gynecology, 59 (1982), 448.Google ScholarPubMed
Joki-Erkkila, M. M. and Heinonen, P. K.. Presenting and long-term clinical implications and fecundity in females with obstructing vaginal malformations. Journal of Pediatric and Adolescent Gynecology, 16 (2003), 307–12.Google Scholar
Williams, C. E., Nakhal, R. S., Hall-Craggs, M. A., et al. Transverse vaginal septae: Management and long-term outcomes. BJOG: An International Journal of Obstetrics & Gynaecology, 121 (2014), 1653–8.CrossRefGoogle ScholarPubMed
Saks, E. K., Vakili, B. and Steinberg, A. C.. Primary amenorrhoea with an abdominal mass at the umbilicus. Journal of Pediatric and Adolescent Gynecology, 22 (2009), e1–3.Google Scholar
Candiani, G. B., Fedele, L. and Candiani, M.. Double uterus, blind hemivagina, and ipsilateral renal agenesis: 36 cases and long-term follow-up. Obstetrics & Gynecology, 90 (1997), 26.Google Scholar
Rock, J. A. and Jones, H. W.. The double uterus associated with an obstructed hemivagina and ipsilateral renal agenesis. American Journal of Obstetrics and Gynecology, 138 (1980), 339–42.CrossRefGoogle ScholarPubMed
Haddad, B., Barranger, E. and Paniel, B. J.. Blind hemivagina: Long-term follow-up and reproductive performance in 42 cases. Human Reproduction, 14 (1999), 1962.Google Scholar
Olive, D. L. and Henderson, D. Y.. Endometriosis and Müllerian anomalies. Obstetrics & Gynecology, 69 (1987), 412–15.Google Scholar
Wallach, E. E., Rock, J. A. and Schlaff, W. D.. The obstetric consequences of uterovaginal anomalies. Fertility and Sterility, 43 (1985), 681–92.CrossRefGoogle Scholar
Letterie, G. S.. Management of congenital uterine abnormalities. Reproductive BioMedicine Online, 23 (2011), 40–52.Google Scholar
Candiani, G. B., Vercellini, P., Fedele, L., et al. Repair of the uterine cavity after hysteroscopic septal incision. Fertility and Sterility, 54 (1990), 991–4.Google Scholar
Yang, J. H., Chen, M. J., Chen, C. D., et al. Optimal waiting period for subsequent fertility treatment after various hysteroscopic surgeries. Fertility and Sterility, 99 (2013), 2092–6.Google Scholar