Analysis of the reproductive outcomes and the size of the unicornuate uterus measured by magnetic resonance imaging and their relationship
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To evaluate the relationship between the uterine size measured by pelvic magnetic resonance and reproductive outcome in women with a unicornuate uterus.
This was a retrospective study including 140 patients affiliated with unicornuate uterus diagnosed by the pelvic MR prior to their first pregnancy in the Obstetrics and Gynecology Hospital of Fudan University from April 2010 to December 2017. All the length of the unicornuate uterus were re-measured and recorded by skilled radiologists during the study period. We divided all the 140 participants with complete pelvic MR imaging into four groups by the best reproductive outcomes, which refers to Group 1 (primary infertility, n = 21), Group 2 ( < 24 weeks’ gestation, n = 34), Group 3 (preterm delivery, 24–35 weeks’ gestation, n = 13), Group 4 ( ≥ 35 weeks’ gestation, n = 72), followed them up and then analyzed the data.
Measurements of 140 patients with hemi-uteri were retrieved for analysis. The mean length of the uterine was 4.90 ± 0.56 cm. There were no significant differences in the uterine cavity length, cervical length, endometrial thickness and uterine wall thickness between the four groups while the uterine length (P = 0.001) was statistically significant. Women with uterine lengths ≥ 4.5 cm were more likely to experience full-term delivery compared with the other group (P = 0.001). Ordinal multiple logistic regression analysis showed that the uterine length [OR = 9.03 (95% CI: 2.90–28.13)] and uterine cavity length [OR = 0.32 (95% CI: 0.06–2.04)] were independent protective factors for better obstetric outcomes
The uterine length is a reliable prognostic factor for the gestational week of delivery and an appropriate antenatal surveillance factor of women with unicornuate uterus.
KeywordsUnicornuate uterus Hemi-uterus Reproductive outcome Obstetric outcomes Uterine size Uterine length
The authors thank the Obstetrics and Gynecology Hospital of Fudan University for supporting in statistical analyses. The authors are grateful to Yuan He for her advice on the data analysis. The authors thank DXJ and KHQ for carefully reviewing the article.
XQL: project development, data management, data analysis, and manuscript writing. HJQ: project development and data management. XYZ: data collection. SFZ: project development. YH: data analysis. KQH: data management. JXD: manuscript revise and project development. All authors read and approved the final manuscript.
This study was supported by the Chinese National Nature Sciences Foundation [grant number 81471416 and 81771524].
Compliance with ethical standards
Conflict of interest
All the authors declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of the Department of Gynecology, the Obstetrics and Gynecology Hospital of Fudan University [2018–18] and informed consent was obtained from each individual.
Informed consent was obtained from all individual participants included in the study.
- 4.The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, mullerian anomalies and intrauterine adhesions (1988). Fertil Steril 49 (6):944-955. doi:10.1016/s0015-0282(16)59942-7Google Scholar
- 5.Grimbizis GF, Gordts S, Di Spiezio Sardo A, Brucker S, De Angelis C, Gergolet M, Li TC, Tanos V, Brolmann H, Gianaroli L, Campo R (2013) The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod 28(8):2032–2044. https://doi.org/10.1093/humrep/det098 CrossRefGoogle Scholar
- 13.Cenksoy PO, Ficicioglu C, Yesiladali M, Akcin OA, Kaspar C (2014) The importance of the length of uterine cavity, the position of the tip of the inner catheter and the distance between the fundal endometrial surface and the air bubbles as determinants of the pregnancy rate in IVF cycles. Eur J Obstet Gynecol Reprod Biol 172:46–50. https://doi.org/10.1016/j.ejogrb.2013.09.023 CrossRefGoogle Scholar
- 14.Chun SS, Chung MJ, Chong GO, Park KS, Lee TH (2010) Relationship between the length of the uterine cavity and clinical pregnancy rates after in vitro fertilization or intracytoplasmic sperm injection. Fertil Steril 93(2):663–665. https://doi.org/10.1016/j.fertnstert.2009.08.067 CrossRefGoogle Scholar
- 15.Grimbizis GF, Di Spiezio SA, Saravelos SH, Gordts S, Exacoustos C, Van Schoubroeck D, Bermejo C, Amso NN, Nargund G, Timmerman D, Athanasiadis A, Brucker S, De Angelis C, Gergolet M, Li TC, Tanos V, Tarlatzis B, Farquharson R, Gianaroli L, Campo R (2016) The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies. Hum Reprod 31(1):2–7. https://doi.org/10.1093/humrep/dev264 CrossRefGoogle Scholar
- 17.Mastrolia SA, Baumfeld Y, Hershkovitz R, Yohay D, Trojano G, Weintraub AY (2018) Independent association between uterine malformations and cervical insufficiency: a retrospective population-based cohort study. Arch Gynecol Obstet 297(4):919–926. https://doi.org/10.1007/s00404-018-4663-2 CrossRefGoogle Scholar
- 19.Kanno Y, Suzuki T, Nakamura E, Goya K, Nishijima Y, Shinoda M, Hayashi M, Izumi S (2014) Successful term delivery after laparoscopic resection of a non-communicating rudimentary horn in a patient with a unicornuate uterus: a case report. Tokai J Exp Clin Med 39(2):59–63Google Scholar
- 21.Jayasinghe Y, Rane A, Stalewski H, Grover S (2005) The presentation and early diagnosis of the rudimentary uterine horn. Obstet Gynecol 105(6):1456–1467. https://doi.org/10.1097/01.AOG.0000161321.94364.56 CrossRefGoogle Scholar
- 22.Pados G, Tsolakidis D, Athanatos D, Almaloglou K, Nikolaidis N, Tarlatzis B (2014) Reproductive and obstetric outcome after laparoscopic excision of functional, non-communicating broadly attached rudimentary horn: a case series. Eur J Obstet Gynecol Reprod Biol 182:33–37. https://doi.org/10.1016/j.ejogrb.2014.08.023 CrossRefGoogle Scholar
- 24.Liu J, Wu Y, Xu S, Su D, Han Y, Wu X (2017) Retrospective evaluation of pregnancy outcomes and clinical implications of 34 Han Chinese women with unicornuate uterus who received IVF-ET or ICSI-ET treatment. J Obstet Gynaecol 37(8):1020–1024. https://doi.org/10.1080/01443615.2017.1318266 CrossRefGoogle Scholar