ASSESSING UTERINE ANOMALIES AS A CRITICAL FACTOR IN RECURRENT MISCARRIAGES
DOI:
https://doi.org/10.54112/pjicm.v5i02.204Keywords:
Miscarriage, Uterine Anomalies, Septate Uterus, SonohysterographyAbstract
Background: Recurrent miscarriage is a distressing reproductive problem, and uterine structural anomalies are recognized contributors. Early identification of these anomalies is essential for appropriate management and improvement of future pregnancy outcomes. Objective: To determine the frequency and types of uterine anomalies among women presenting with recurrent miscarriages. Study Design: Descriptive cross-sectional study. Setting: Conducted in a tertiary care gynecology department. Duration of Study: From January 2025 to August 2025. Methods: Eighty women with a history of two or more consecutive pregnancy losses were evaluated. All participants underwent transvaginal ultrasonography to detect uterine anomalies, including septate uterus, arcuate uterus, bicornuate uterus, didelphys uterus, and endometrial polyps, according to established ultrasonographic criteria. Data analysis was performed using SPSS version 27. Descriptive statistics were used to report frequencies, percentages, and mean values. Results: The mean age of the participants was 28.13 ± 5.16 years. More than half of the women (52.5%, n = 42) had experienced more than three miscarriages. Uterine anomalies were detected in 40% of the cohort (n = 32). The most frequent anomalies were a septate uterus (15% n = 12), an arcuate uterus (10% n = 8), and endometrial polyps (8.8% n = 7). Conclusion: Uterine anomalies were identified in a substantial proportion of women with recurrent miscarriages, emphasizing their role as a significant etiological factor. Septate uterus, arcuate uterus, and endometrial polyps were the most common findings. Early detection using transvaginal ultrasound may improve reproductive outcomes.
References
Kanmaz AG, Inan AH, Beyan E, Budak A. The effects of threatened abortions on pregnancy outcomes. Ginekol Pol. 2019;90(4):195-200. https://doi.org/10.5603/GP.a2019.0035
Dugas C, Slane VH. Miscarriage. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532992/ (DOI not available)
Ansari S, Shah RK, Ansari MA, Mushtaq R, Deep JP, Khatun T, et al. Vaginal bleeding in early pregnancy: patterns, predictors and association with miscarriage. Med Phoenix. 2024;9(1):17-23. https://doi.org/10.3126/medphoenix.v9i1.67180
Fernlund A, Jokubkiene L, Sladkevicius P, Valentin L. Predictors of complete miscarriage after expectant management or misoprostol treatment of non-viable early pregnancy in women with vaginal bleeding. Arch Gynecol Obstet. 2020;302(5):1279-1296. https://doi.org/10.1007/s00404-020-05672-6
Shaker M, Smith A. First-trimester miscarriage. Obstet Gynecol Clin North Am. 2022;49(3):623-635. https://doi.org/10.1016/j.ogc.2022.04.004
Carrascosa P, Capuñay C. Normal radiologic anatomy of the female reproductive system. In: Carrascosa P, Capuñay C, Baronio JM, Papier S, editors. Clinical Atlas of CT Virtual Hysterosalpingography. Cham: Springer; 2021. p. 7-39. https://doi.org/10.1007/978-3-030-66207-3_2
Saravelos SH, Cocksedge KA, Li TC. The pattern of pregnancy loss in women with congenital uterine anomalies and recurrent miscarriage. Reprod Biomed Online. 2010;20(3):416-422. https://doi.org/10.1016/j.rbmo.2009.11.021
Preisler J, Kopeika J, Ismail L, Vathanan V, Farren J, Abdallah Y, et al. Defining safe criteria to diagnose miscarriage: prospective observational multicentre study. BMJ. 2015;351:h4579. https://doi.org/10.1136/bmj.h4579
Mukhopadhaya N, Asante GP, Manyonda IT. Uterine fibroids: impact on fertility and pregnancy loss. Obstet Gynaecol Reprod Med. 2007;17(11):311-317. https://doi.org/10.1016/j.ogrm.2007.08.005
Leon IG. Helping families cope with perinatal loss. The Global Library of Women's Medicine. 2008 Apr. https://doi.org/10.3843/glowm.10418
Hirayama E, Ebina Y, Kato K, Akabane-Nakagawa K, Okuyama K. Cervical polyps in early pregnancy are a risk factor for late abortion and spontaneous preterm birth: a retrospective cohort study. Int J Gynaecol Obstet. 2022;156(1):64-70. https://doi.org/10.1002/ijgo.13608
Habib R, Mufti AH, Wani NJ. Structural uterine anomalies in recurrent pregnancy loss. Int J Reprod Contracept Obstet Gynecol. 2019;8(5):2039-2043. https://doi.org/10.18203/2320-1770.ijrcog20191963
Pervaiz S, Naeem MA, Ali A, John A, Batool N. Frequency of uterine anomalies associated with persistent miscarriages in pregnancy on ultrasound. Pak J Health Sci. 2022;3(1):55-58. https://doi.org/10.54393/pjhs.v3i01.54
Yasmeen R, Hussain R. Recurrent miscarriage and associated factors. Pak J Med Dent. 2016;5(1):47-50.
Carbonnel M, Pirtea P, de Ziegler D, Ayoubi JM. Uterine factors in recurrent pregnancy losses. Fertil Steril. 2021;115(3):538-545. https://doi.org/10.1016/j.fertnstert.2020.12.003
Turocy JM, Rackow BW. Uterine factor in recurrent pregnancy loss. Semin Perinatol. 2019;43(2):74-79. https://doi.org/10.1053/j.semperi.2018.12.003
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