[Clinical analysis of 225 women with congenital uterine malformation]

To investigate the prevalence, clinical features, diagnosis, treatment and the influence on procreation of uterine malformation.

Totally 225 women with uterine malformation referred to our hospital from Mar 1990 to Jan 2005 were involved in this retrospective analysis. The constituent ratio, clinical feature, diagnosis, treatment and the influence on procreation were analyzed.

(1) Among 225 cases of uterine malformation, 125 cases (55.6%) were septate uterus; 122 (97.6%, 122/125) of these patients became pregnant, but always associated with a high risk of reproductive failure and obstetrical complications, such as abortion, abnormal fetal presentation, premature rupture of membrane. (2) Among 51 cases (22.7%, 51/225) of didelphia, 50 cases (98%, 50/51) became pregnant without any influence from this malformation. Five cases were combined with urinary system complication. (3) Among 26 cases (9.7%, 26/225) of rudimentary horn of uterus, 4 cases (15%, 4/26) became pregnant, and 1 case (4%, 1/26) presented with ipsilateral oviduct ectopic pregnancy; 2 cases (8%, 2/26) were combined with urinary deformities. (4) In 14 cases (6.2%, 14/225) of bicornuate uterus, 1 case (7%, 1/14) presented with urinary tract abnormalities; gestations were more common, but due to the uterine structural abnormality, recurrent miscarriage and premature delivery were unavoidable. (5) Others: none came up with sterility in 4 cases (1.8%, 4/225) of saddle shaped uterus. All the three cases (1.3%, 3/225) of ametria were with the chief complaint of primary amenorrhea. Two cases of unicornis uterus (0.9%, 2/225) were both complicated with sterility, while neither with urinary system deformities.

Among uterine malformations, septate uterine is the most common type. Septate uterus, didelphic uterus, bicornuate and rudimentary horn of uterus do not affect pregnancy, but can cause different complications. Unicornis uterus always causes sterility. Uterus malformations often come up with urinary system deformities.