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Midline uterine defect size is correlated with miscarriage of euploid embryos in recurrent cases
Mayumi Sugiura-Ogasawara1, Yasuhiko Ozaki, Tamao Kitaori
1Department of Obstetrics and Gynecology, Nagoya City University, Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Japan. og.mym@med.nagoya-cu.ac.jp
Objective:
To compare subsequent pregnancy outcomes after two or more miscarriages in patients with and without congenital uterine anomalies.
Design:
Case-control study.
Setting:
Nagoya City University Hospital.
Patient(S):
A total of 42 patients with a bicornuate or septate uterus and 1528 with normal uteri.
Intervention(S):
No surgery.
Main Outcome Measure(S):
The cumulative success rate for birth, abnormal chromosome karyotype rate in aborted concepti, and the predictive values of the height of the defect/length of the remaining uterine cavity ratio (D/C ratio).
Result(S):
Of the total of 1676 patients, 54 (3.2%) had congenital uterine anomalies; 25 (59.5%) of the 42 patients with a bicornuate or septate uterus had a successful first pregnancy after examination, while this was the case for 1096 (71.7%) of the 1528 with normal uteri. There was no difference in the cumulative live-birth rate (78.0% and 85.5%) within the follow-up period. However, the rates for an abnormal chromosome karyotype in aborted concepti in cases with and without uterine anomalies were 15.4% (two of 13) and 57.5% (134 of 233), respectively, with the latter being significantly higher. The D/C ratio in the miscarriage group was also significantly greater than that for the live-birth group.
Conclusion(S):
Congenital uterine anomalies have a negative impact on reproductive outcome in couples with recurrent miscarriage and are associated with further miscarriage with a normal embryonic karyotype. The D/C ratio was found to have a predictive value for further miscarriages in recurrent cases.
