Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-21T17:38:51.710Z Has data issue: false hasContentIssue false

Chapter 5 - Congenital Uterine Malformations and Vaginal Anomalies

Published online by Cambridge University Press:  14 July 2023

By
Bibi Zeyah Fatemah Sairally  and
Pallavi Latthe
Edited by
Swati Jha  and
Priya Madhuvrata
Swati Jha
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
Priya Madhuvrata
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
Get access

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.

Keywords

septatebicornuatedidelphyscongenital uterine anomaliespregnancyoutcomevaginal septum
Type
Chapter
Information
Gynaecology for the Obstetrician , pp. 40 - 49
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×