Critical Care Obstetrics and Gynecology

Pattern of Congenital Uterine Anomalies among Infertile Women With and Without Recurrent Miscarriages, in Southwest Nigeria

Study: To determine the prevalence and pattern of congenital uterine anomalies (CUA) detected at hysteroscopy among infertile women (IW) in Southwest Nigeria.
Design: Clinical retrospective cohort study Setting: Nordica Fertility Center, a private establishment in, Lagos, Nigeria.
Patients: One thousand one hundred and eighteen consecutive infertile women.
Intervention: Hysteroscopy
Main outcome measure(s): Congenital uterine anomalies, type of anomalies, miscarriages
Results: Of the 1118 IW examined, 26 (2.3%) had CUA, majority of which were sub-septate uterus (19/26; 73.1%); others were bicornuate (3, 11.5%), arcuate (2, 7.7%), unicornuate (1, 3.8%) and intracervical septum (1, 3.8%).The means (± SD) of age (years), BMI (Kg/m2) and duration of subfertility (years)among IW with CUA were 38.7 (6.6), 27.4 (5.9) and 7.5 (6.9) respectively. CUA was more prevalent among IW in the age group of 35-39 years (9/26; 34.6%), in overweight (15/26, 57.7%). 24 (92.3%) had secondary infertility and 9 (34.6%) gave a history of spontaneous miscarriage. The mean uterine cavity depth of IW with CUA (7.81 ± 1.01; 95% CI= 7.4, 8.2) was significantly smaller (t= -2.26, df=27.7, P-value=0.015) than that of IW without CUA (8.27 ± 1.50; 95% CI= 8.2, 8.4). Among IW with CUA, 1 (3.8%) had obliterated right ostium while 2 (7.7%) had obliterated left ostium.
Conclusion: The 2.3% CUA prevalence among IW was comparable to other studies. Sub-septate uterus was the most frequent CUA. Majority of the IW with CUA had secondary infertility and significantly smaller uterine cavity depth.
Recommendation: Our study suggested that not combining laparoscopy with hysteroscopy is a relatively minor hindrance in diagnosis.

Author(s):

Abayomi Ajayi, Victor Ajayi, Oluwafunmilola Biobaku, Ifeoluwa Oyetunji, Happiness Aikhuele, Oladapo Adejuwon and Bamgboye M Afolabi

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