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Bobkova M.V.
Federal State Budget Institution «Research Center for Obstetrics, Gynecology and Perinatology» (dir. — Acad. RAN G.T. Sukhikh) Moscow, Russia, 117997
Puchko T.K.
Nauchnyĭ tsentr akusherstva, ginekologii i perinatologii im. akad. V.I. Kulakova
Adamyan L.V.
Department of Reproductive Medicine and Surgery, Faculty of Postgraduate Professional Education, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia
Reproduction in women with congenital uterus and vagina anomalies
Journal: Russian Journal of Human Reproduction. 2018;24(2): 42‑53
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To cite this article:
Bobkova MV, Puchko TK, Adamyan LV. Reproduction in women with congenital uterus and vagina anomalies. Russian Journal of Human Reproduction.
2018;24(2):42‑53. (In Russ.)
https://doi.org/10.17116/repro201824242-53
Objective — to study the reproduction outcomes in women with uterine and vaginal malformations compared to women without such pathology. Material and methods. Retrospective reproductive outcomes in women with congenital uterine and vaginal anomalies as well as early neonatal period of their children were studied during 2005—2015 yy in Obstetric departments of National Research Center for Obstetric, Gynecology and Perinatology named after academician V.I. Kulakov of Ministry of Healthcare of Russia. 806 pregnant women with congenital uterine and vagina anomalies were included: 222 — with bicornuate uterus, 17 — with unicornuate uterus, 66 — with intrauterine septa, including 15 women after septum resection before pregnancy, arcuate uterus were in 457, didelphys uterus and vagina — in 35, urinary bladder extrophy — 6 and vaginal septum alone — in 3 patients. 307 pregnant women without congenital uterine and vaginal malformations were comprised to control group. Heredity, obstetric and gynecologic anamnesis, concomitant gynecologic and extragenital diseases, current pregnancy complications, delivery and early postpartum period, placental pathology, neonatals morbidity were studied. Statistical analysis was performed using Microsoft Office Excel 2009 and IBM SPSS Statistics 8 with Student and Pirson criteria. Results. Pregnancy in women with congenital uterus and vagina malformations represent high risk of complications and reproductive failure due to premature labor, placental insufficiency (from 16 to 29%, depending of the type of uterine and vagina anomaly) and intrauterine growth retardation (10%). Among all types of congenital uterus anomalies past obstetric complications more often were observed in pregnant women with bicornuated uterus (62%) and intrauterine septum (60%). Miscarriage in past were prevalent in the same category patients in 42 and 44% cases respectively. Premature labor (in past and during current pregnancy) were more often observed in women with bicornuated uterus (30%) and intrauterine septum (23%). Breech presentation was more often observed in pregnant women with uterus and vagina duplex (43%) while among all pregnant with uterus and vagina anomaly this indicator averaged 19% and 4% — in the control group. Cesarean delivery took place in 87,3% incidence among women with uterine and vaginal anomaly, and only in 28.9% — among women in the control group. Conclusion. Our study found significant risk of complicated pregnancy from early first-trimester period, fetal malpresentation and unfavorable neonatal outcomes in women with uterine and vaginal anomalies. That’s why it is very important to counsel women with mullerian anomaly during preparing for pregnancy, properly take care and monitor the course of pregnancy from the beginning of gestation, flexible and adequate tactics of pregnancy management and preventive correction of possible complications as well as proper monitor of fetal condition according to gestational age, planning of the delivery method and terms.
Authors:
Bobkova M.V.
Federal State Budget Institution «Research Center for Obstetrics, Gynecology and Perinatology» (dir. — Acad. RAN G.T. Sukhikh) Moscow, Russia, 117997
Puchko T.K.
Nauchnyĭ tsentr akusherstva, ginekologii i perinatologii im. akad. V.I. Kulakova
Adamyan L.V.
Department of Reproductive Medicine and Surgery, Faculty of Postgraduate Professional Education, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia
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