Analysis of postoperative pregnancy outcome in 180 women with congenital uterine malformation.

INTRODUCTION: This study aims to explore the effects of combination of laparoscopy and hysteroscopy in pregnancy outcome in women diagnosed with congenital uterine malformation (CUM). The observation criteria include pregnancy rate, misdiagnosis rate, rate of spontaneous abortion and preterm birth rate.

MATERIAL AND METHODS: A total of 180 patients with congenital uterine malformation, who were treated in our hospital from January 2015 to June 2018, were enrolled in the study. Prior to hospitalization, all the patients had neither a history of genital tract surgery nor endocrine abnormalities, chromosomal abnormalities, immune abnormalities or other factors affecting pregnancy. Furthermore, the ovarian functions were normal, and there were no factors leading to infertility in the male partners. The diagnosis was mainly based on medical history, clinical manifestations, gynecological examinations, and ultrasonography including two-dimensional and three-dimensional ultrasonography, as well as hysterosalpingogram (HSG), magnetic resonance imaging (MRI), hysteroscopy, and/or laparoscopy or surgery. Patients were diagnosed and classified according to the Buttram classification.

RESULTS: Among these 180 patients, 37 patients were diagnosed with complete septate uterus, 96 patients had sub-septate uterus, 25 patients had unicornuate uterus, 11 patients were diagnosed with bicornuate uterus, and 11 patients had didelphic uterus. The total number of preoperative pregnancies was 112, including 106 spontaneous abortions, with an abortion rate of 94.64%, and 86 total postoperative pregnancies, among which spontaneous abortions occurred 11 times, with an abortion rate of 12.79%. The difference was statistically significant ( p < 0.05).

CONCLUSIONS: Uterine malformation surgery can significantly improve the reproductive prognosis in patients with CUM.