Anatomic factors associated with recurrent pregnancy loss

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Obstetrics

Background:

• Anatomic uterine defects are linked to reproductive challenges, including pregnancy loss and preterm birth.
• These defects are categorized as congenital (e.g., müllerian anomalies) or acquired (e.g., fibroids).
• Müllerian anomalies are identified in 8-10% of women with recurrent spontaneous abortions.

Purpose of the Study:

• To review the impact of uterine anomalies on reproductive outcomes.
• To discuss the classification and mechanisms of reproductive difficulties associated with uterine defects.
• To highlight potential treatment strategies for improving pregnancy success in affected women.

Main Methods:

• Literature review of studies on uterine anomalies and reproductive outcomes.
• Analysis of diagnostic methods like hysterosalpingography and hysteroscopy.
• Discussion of surgical and non-surgical interventions.

Main Results:

• Uterine anomalies contribute to first- and second-trimester losses, preterm labor, and abnormal fetal presentation.
• Müllerian anomalies may cause recurrent pregnancy loss due to vascular, volume, or cervical factors.
• Specific anomalies like uterine septum and bicornuate uterus are common and associated with poor reproductive history.

Conclusions:

• Recurrent pregnancy losses due to uterine septum, bicornuate uterus, adhesions, or fibroids can often be surgically corrected.
• Prophylactic cervical cerclage may benefit women with müllerian anomalies experiencing second-trimester losses.
• Addressing uterine anatomic defects is crucial for improving reproductive success.