Structural uterine abnormalities

The prevalence and reproductive implications of uterine anomalies in the general population have not been clearly established. Hence, it is difficult to assess the contribution that congenital uterine anomalies make to RM. The prevalence of uterine anomalies among women with RM has been reported to range between 1.8% and 37.6% [30]. This wide range reflects the differences in criteria and techniques used for diagnosis and the fact that available studies have included women with two, three or more miscarriages at both early and late stages of pregnancy. A recent retrospective review of reproductive performance in patients with untreated uterine anomalies has suggested that these women experience high rates of miscarriage and preterm delivery [31]. Open uterine surgery is associated with post-operative infertility and carries a significant risk of uterine scar rupture during pregnancy. These complications are less likely to occur after hysteroscopic surgery but no randomized trial assessing the benefits of surgical correction of

60 50 40 30

8 20

10 0

Age (years)

Fig. 13.4 Outcome of index pregnancy is related to maternal age.

8 30

Number of previous miscarriages

Fig. 13.5 Outcome of index pregnancy is related to number of previous miscarriages.

uterine abnormalities on pregnancy outcome has been performed.

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