A comparative study of the morphology of congenital uterine anomalies in women with and without a history of recurrent first trimester miscarriage

TLDR

The true impact of congenital uterine anomalies on reproductive outcomes is unknown. The study examined differences in uterine anomaly morphology between women with and without recurrent miscarriage using 3D ultrasound on 509 and 1976 participants. Uterine anomalies were classified by the American Fertility Society, and fundal distortion size and remaining cavity length were measured to compute a distortion ratio, then compared between the two groups. No overall difference in anomaly frequency or fundal distortion depth was found, but arcuate and subseptate uteri in the recurrent miscarriage group had shorter remaining cavities and higher distortion ratios, indicating more severe distortion.

Abstract

The true impact of congenital uterine anomalies on reproductive outcomes is unknown. The aim of this study was to examine differences in the morphology of uterine anomalies found in women with and without a history of recurrent miscarriage.A total of 509 women with a history of unexplained recurrent miscarriage and 1976 low risk women were examined for the presence of congenital uterine anomalies by three-dimensional ultrasound. The anomalies were classified according to the American Fertility Society classification. In addition, the size of fundal distortion (F) and the length of the remaining uterine cavity (C) were measured to calculate a distortion ratio (F/F+C). The findings were compared with the measurements obtained in low risk women with an incidental finding of uterine anomaly.In all, 121 anomalies were detected in the recurrent miscarriage group and 105 in low risk women. There was no significant difference in relative frequency of various anomalies or depth of fundal distortion between the two groups. However, with both arcuate and subseptate uteri, the length of remaining uterine cavity was significantly shorter (P < 0.01) and the distortion ratio was significantly higher (P < 0.01) in the recurrent miscarriage group.The distortion of uterine anatomy is more severe in congenital anomalies, which are found in women with a history of recurrent first trimester miscarriage.