Uterus and Miscarriage
Arcuate Uterus and Miscarriage
Arcuate uterus doubles risk of second trimester miscarriage
We identified nine studies comprising 3805 women. Meta-analysis showed that arcuate uteri were associated with increased rates of second-trimester miscarriage (relative risk, 2.39) and fetal malpresentation at delivery (head not facing downward) (relative risk, 2.53). Canalization defects were associated with reduced clinical pregnancy rates (relative risk, 0.86) and increased rates of first-trimester miscarriage (relative risk, 2.89), preterm birth (relative risk, 2.14) and fetal malpresentation (relative risk, 6.24). Unification defects were associated with increased rates of preterm birth (relative risk 2.97) and fetal malpresentation (relative risk, 3.87). CONCLUSIONS: Canalization defects reduce fertility and increase rates of miscarriage and preterm delivery. None of the unification defects reduces fertility but some are associated with miscarriage and preterm delivery. Arcuate uteri are specifically associated with second-trimester miscarriage. All uterine anomalies increase the chance of fetal malpresentation at delivery.
Arcuate uterus is not associated with history of miscarriage, infertility, or preterm delivery
This review aims to evaluate the prevalence of such anomalies in unselected populations and in women with infertility, including those undergoing IVF treatment, women with a history of miscarriage, women with infertility and recurrent miscarriage combined, and women with a history of preterm delivery. RESULTS: We identified 94 observational studies comprising 89,861 women. The prevalence of uterine anomalies diagnosed by optimal tests was 5.5% in the unselected population, 8.0% in infertile women, 13.3% in those with a history of miscarriage and 24.5% in those with miscarriage and infertility. Arcuate uterus is most common in the unselected population (3.9%), and its prevalence is not increased in high-risk groups. In contrast, septate uterus is the most common anomaly in high-risk populations. CONCLUSIONS: Women with a history of miscarriage or miscarriage and infertility have higher prevalence of congenital uterine anomalies compared with the unselected population.
Arcuate uterus not associate with first trimester miscarriage or reduced pregnancy rate
One thousand three hundred and eighty-five subjects were included for final analysis. The pregnancy rates in women with arcuate uteri (36/66 (54.5%)) and major uterine anomalies (7/10 (70.0%)) were statistically similar (P = 0.09 and P = 0.11, respectively) to that of the matched controls with normal uteri (158/364 (43.4%)). While first-trimester miscarriage rates were similar (P = 0.81) between the control group (20/158 (12.7%)) and women with arcuate uteri (5/36 (13.9%)), women with major uterine anomalies experienced a higher miscarriage rate (3/7 (42.9%); P = 0.05). CONCLUSIONS: Women who are referred for ART have a high prevalence of congenital uterine anomalies, the most common anomaly being an arcuate uterus. These anomalies are not associated with a reduction in pregnancy rates following ART. However, while the arcuate uterus was not associated with an increase in first-trimester miscarriage, major uterine anomalies seemed to increase the risk of first-trimester miscarriage.
Arcuate uterus associated with lower gestational age and birth weight
The pregnancy outcomes, past and present, of 105 women with congenital uterine anomalies were compared with those of 182 women with a normally shaped uterus. Among women with arcuate uteri, significantly lower gestational age and birth-weight were observed compared with any other type of adverse outcome.
Arcuate uterus increases risk of second trimester loss and preterm labor
We studied 1089 women with no history of infertility or recurrent miscarriage who were seen for a transvaginal ultrasound scan. They were screened for uterine abnormalities using three-dimensional ultrasound. We determined prevalence of miscarriage and preterm labor in women with normal and abnormal uterine morphology. RESULTS: Women with a subseptate uterus had a significantly higher proportion of first-trimester loss (Zeta = 4.68, P <.01) compared with women with a normal uterus. Women with an arcuate uterus had a significantly greater proportion of second-trimester loss (Zeta = 5.76, P <.01) and preterm labor (Zeta = 4.1, P <.01). There were no other significant differences in pregnancy outcomes between women with normal and abnormal uterine morphology.