Incidence and types of congenital uterine anomalies during C-section

Improper development of the Mullerian ducts causes congenital uterine anomalies, which are linked to adverse reproductive outcomes such as – recurrent miscarriage, preterm birth, fetal malpresentation, and subfertility. The prevalence of these anomalies in the general population is estimated to be 5-7%. The objective of a new study was to determine the frequency and types of congenital uterine anomalies observed during cesarean section (C-section) delivery.

This prospective cohort study was conducted at SDM College of Medical Sciences and Hospital, Dharwad, India, from 2020-2021. The study involved 2,932 women undergoing C-sections. A systematic examination of the uterus, both internally and externally, was performed after the delivery of the baby and placenta, noting the type of uterine anomaly.

Overall, 22 cases of congenital uterine anomalies were found during the C-sections––indicating a prevalence of 0.75%. Women with uterine anomalies showed an increased incidence of adverse outcomes, including miscarriage (27%), pre-eclampsia (31.8%), fetal malpresentation (31.8%), fetal growth restriction (9%), and preterm C-section (40.9%). The most common types of congenital uterine anomalies were unicornuate uterus (31.8%), septate (27.2%), arcuate (22.7%), and bicornuate uterus (18.1%). The poorest outcomes were observed with septate and unicornuate uteri.

From the results, it was inferred that C-section offers an opportunity to diagnose congenital uterine anomalies, providing valuable information for planning future reproductive decisions. Hence, a thorough examination of the uterus should be considered a routine step during C-section procedures.

Source: Patil M, Patil V. Indian J Obstet Gynecol Res. 2023 (Ahead of print).