[Uterine malformations. Diagnosis, prognosis and treatment]

Malformations of the uterus result from a variety of anomalies during embryogenesis from the 6th to the 17th week of development. Agenesia (not discussed here) should be distinguished from unicornis, pseudo-unicornis, bicornis, bipartitus and communicating uteri (Musset's classification). Such malformations occur in 3 to 4% of all women. Sonography provides the most useful information for diagnosis and should be used as first intention examination together with a work-up to determine extension. In certain cases, hysterography and laparoscopy may be required. Sterility is not increased in women with a malformation of the uterus, but fecundity is reduced due to a high rate of spontaneous abortions (30 to 40%) and premature births (15 to 45%). Obstetrical prognosis in case of a partitioned uterus can be improved by hysteroscopic resection of the partition. Most authors propose endoscopic treatment when a malformation of the uterus is diagnosed during a sterility work-up.