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Ultrasonographically detected uterine synechiae and their impact on pregnancy outcomes
Ecem Okşen1, Selvi Aydın Şenel1, Hale Özer Çaltek1
1Department of Perinatology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
ObjectiveTo evaluate the association between uterine synechiae and obstetric outcomes and to identify factors associated with their presence in a retrospective observational cohort.
ObjectiveTo evaluate the association between uterine synechiae and obstetric outcomes and to identify factors associated with their presence in a retrospective observational cohort.
Methods:
This retrospective observational cohort study included 120 pregnant women, comprising 60 women with uterine synechiae and 60 without synechiae. Demographic characteristics, obstetric history, and pregnancy outcomes were compared between groups. Ultrasonographic characteristics, including synechiae thickness, were recorded. Multivariable logistic regression analysis was performed to identify factors independently associated with uterine synechiae.
Results:
Maternal age was similar between groups; however, gravidity and parity were significantly higher in women with uterine synechiae (p < 0.05). Prior curettage was significantly more frequent in the uterine synechiae group than in the control group (50.0% vs. 20.0%, p = 0.001). Gestational age at delivery was significantly lower in the synechiae group compared with controls (36.45 ± 3.57 vs. 37.95 ± 1.90 weeks, p = 0.036). Among pregnancies that reached delivery, normal spontaneous vaginal delivery was more frequent in women with synechiae, whereas cesarean section rates were comparable. Malpresentation did not differ significantly between groups. In multivariable analysis, previous curettage (OR: 3.84, 95% CI: 1.36-7.76, p = 0.001) and prior vaginal delivery (OR: 2.58, 95% CI: 1.02-6.50, p = 0.039) were independently associated with the presence of uterine synechiae.
Conclusion:
Pregnancies with ultrasonographically detected uterine synechiae were characterized by a higher prevalence of previous uterine curettage and a lower mean gestational age at delivery compared with matched controls. Although preterm birth rates were similar between groups, these findings suggest a possible association between uterine synechiae and certain pregnancy characteristics. Further prospective studies are needed to clarify their clinical significance.