Pregnancy Outcomes in Patients with Obstructed Hemivagina Ipsilateral Renal Agenesis.

STUDY OBJECTIVE: Obstructed Hemivagina with Ipsilateral Renal Agenesis (OHVIRA) is a rare congenital Müllerian anomaly. We sought to explore the impact of OHVIRA on pregnancy outcomes.

METHODS: A retrospective chart review identified eight patients with an OHVIRA diagnosis and at least one documented pregnancy. Data collected included demographics, age at diagnosis and repair, gynecologic history, and pregnancy outcomes. Descriptive analysis was performed.

RESULTS: Twenty-three pregnancies were identified among the eight patients (range 1-5 pregnancies per patient), resulting in nine term births, six preterm births, and eight first-trimester spontaneous abortions. The most common pregnancy complications were fetal growth restriction (2/15) and preeclampsia with severe features (2/15). The average gestational age at delivery was 37 2/7 weeks; however, 60% (9/15) of live births were at term. Two patients delivered after going into preterm labor, one of whom also had preterm premature rupture of membranes. Of the 15 live births, there were 10 cesarean deliveries, four vaginal deliveries, and one forceps-assisted vaginal delivery. Three patients (30%) underwent primary cesarean deliveries due to fetal malpresentation. Five live births were repeat cesarean deliveries and two were unscheduled cesareans, at 34 and 36 weeks, due to preeclampsia with severe features.

CONCLUSION: This study is among the first to examine pregnancy outcomes in patients with OHVIRA. Among these patients, there were 23 total pregnancies, with higher incidences of spontaneous abortion, preterm birth, breech presentation, and cesarean delivery compared to the general population. This descriptive dataset addresses a knowledge gap to help clinicians more effectively advise patients with OHVIRA about pregnancy outcomes.