Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 5, September-October, p. 873–879

doi: 10.17219/acem/23171

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Pregnancy and Delivery in Women with Uterine Malformations

Monika M. Żyła1,A,B,C,D,E,F, Jan Wilczyński2,A,B,C,D,E,F, Agata Nowakowska-Głąb3,C,E,F, Irena Maniecka-Bryła3,C,E,F, Dorota Nowakowska2,A,B,C,D,E,F

1 Department of Gynecology and Oncological Gynecology, Polish Mother’s Memorial Hospital Research Institute in Łódź, Poland

2 Department of Maternal-Fetal Medicine and Gynecology, Polish Mother’s Memorial Hospital Research Institute in Łódź, Poland

3 Department of Epidemiology and Biostatistics, Medical University in Łódź, Poland


Background. Uterine defects are the most common malformations of the female reproductive system. They can lead to many obstetric complications, e.g. preterm delivery, intrauterine growth restriction, oligohydramnios and operational delivery.
Objectives. Our aim was to analyze the impact of different types of uterine defects on pregnancy outcomes.
Material and Methods. The study involved 94 pregnant women with different types of uterine defects hospitalized at the Department of Fetal – Maternal Medicine and Gynecology, RIPMMH in Łódź, between 1994 and 2012. The patients were divided into 5 groups on the basis of diagnosed defects: arcuate (n = 6), bicornuate (n = 50), duplex (n = 29), septate (n = 5) and unicornuate uterus (n = 4). In order to avoid correlated data in statistical analysis, our research did not consider the total number of pregnancies and births but the number of patients. The first pregnancy of each patient, if completed after 22-week gestation, was studied and analyzed.
Results. Preterm delivery was the most common complication in pregnancy (55 women, 58.5%). The caesarean section was performed in 73 (78%) women. IUGR was diagnosed in 16% of cases. Placental abruption occurred in 13 (14%) and cervical insufficiency in 10 cases (11%), respectively. Prenatal diagnostic showed abnormalities in 12 fetuses (13%). The Apgar score from 0 to 4 points was assigned to 9 newborns (9.6%), 5–7 to 20 children (21.3%) and 8–10 points to 75 cases (69.1%). Normal birth weight (> 2500 g) was determined in 51 newborns (54.3%).
Conclusion. Women with uterine defects are subject to an increased risk of complications in pregnancy and delivery, including premature births, low birth weights, births by cesarean section.

Key words

pregnancy, caesarean section, preterm delivery, uterine malformations

References (26)

  1. Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simón C, Pellicer A: Reproductive impact of congenital mullerian anomalies. Hum Reprod 1997, 12, 2277–2281.
  2. Lin PC, Bhatnagar KP, Nettleton GS, Nakajima ST: Female genital anomalies affecting reproduction. Fertil Steril 2002, 78, 899–915.
  3. Grimbizis GF, Campo R: Clinical approach for the classification of congenital uterine malformations. Gynecol Sur 2012, 9, 119–129.
  4. Rechberger T, Kulik-Rechberger B: Congenital anomalies of the female reproductive tract – diagnosis and management. Ginekol Pol 2011, 82, 137–145.
  5. Golan A, Langer R, Bukovsky I, Caspi E: Congenital anomalies of the mullerian system. Fertil Steril 1989, 51, 747–755.
  6. The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, mullerian anomalies and intrauterine adhesions. Fertil Steril 1988, 49, 944–955.
  7. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Mathews TJ, Osterman MJ: Births: final data for 2008. Nati Vital Stat Rep 2010, 59, 1–71.
  8. Phelan JP, Ahn MO, Smith CV, Rutherford SE, Anderson E: Amniotic fluid index measurements during pregnancy. J Reprod Med 1987, 32, 601–604.
  9. Resnik R: High-risk pregnancy series: an experts view: intrauterine growth restriction. Obstet Gynecol 2002, 99, 490–496.
  10. Bhattacharya S, Bhattacharya S: Effect of miscarriage on future pregnancies. Women’s Health 2009, 5, 5–8.
  11. Acien P: Reproductive performance of women with uterine malformations. Hum Reprod 1993, 8, 122–126.
  12. Gruszka M, Wilczyński J, Nowakowska D: Prevalence of uterine malformations and their impact on fertility. Ginekol Pol 2012, 83, 517–521.
  13. Zlopasa G, Skrablin S, Kalafatic D, Banović V, Lesin J: Uterine anomalies and pregnancy outcome following resectoscope metroplasty. Int J Gynecol Obstet 2007, 98, 129–133.
  14. Slattery MM, Morrison JJ: Preterm delivery. The Lancet 2002, 360, 1489–1497.
  15. Goldenberg RL, Culhane JF, Iams JD, Romero R: Epidemiology and causes of preterm birth. The Lancet 2008, 371, 75–84.
  16. Heinonen PK: Reproductive performance of women with uterine anomalies after abdominal or hysteroskopic metroplasty or no surgical treatment. J Am Assoc Gynecol Laparosc 1997, 4, 311–317.
  17. Wilkinson C, McIlwaine G, Boulton-Jones C, Cole S: Is a rising cesarean section rate inevitable? B J Obstet Gynecol 1998, 105, 45–52.
  18. Belizan JM, Althabe F, Barros FC, Alexander S: Rates and implications of cesarean section in Latin America: ecological study. BJM 1999, 319, 397–402.
  19. Curtin SC: National Center for Health Statistics. Rates of cesarean birth and vaginal birth after previous cesarean 1991–1995. Mon Vital Stat Rep 1997, 45, Suppl 3.
  20. Latham S, Norwitz T: Ethics and “Cesarean Delivery on Maternal Demand”. Semin Perinatol 2009, 33, 405–409.
  21. Rates of cesarean delivery – United States 1993. Morb Mortal Wkly Rep 1995, 44, 303–307.
  22. Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, Shah A, Campodónico L, Bataglia V, Faundes A, Langer A, Narváez A, Donner A, Romero M, Reynoso S, de Pádua KS, Giordano D, Kublickas M, Acosta A: WHO 2005 global survey on maternal and perinatal health research group: Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. The Lancet 2006, 367, 1819–1829.
  23. Jayasinghe Y, Rane A, Stalewski H, Grover S: The presentation and early diagnosis of the rudimentary uterine horn. Obstet Gynecol 2005, 105, 1456–1467.
  24. Martinez-Frias ML, Bermejo E, Rodriguez-Pinilla E, Frías JL: Congenital anomalies in the offspring of mothers with a bicornuate uterus. Pediatrics 1998, 101, 693–694.
  25. Nowakowska-Głąb A, Maniecka-Bryła I, Wilczyński J, Nowakowska D: Ocena jakości życia kobiet hospitalizowanych w ciąży z wykorzystaniem Mother-Generated Index – badanie pilotażowe. Ginekol Pol 2010, 81, 521–527.
  26. Symon A, Nagpal J, Maniecka-Bryła I, Nowakowska-Głąb A, Rashidian A, Khabiri R, Mendes I, Pinheiro A, Fontenele de Oliveira M, Wu L: Cross-cultural adaptation and translation of a quality of life tool for new mothers: a methodological and experiential account from six countries. J Adv Nurs 2013, 69, 970–980.