Skip to main content
SpringerLink
Log in

Uterine Fehlbildungen

  • Living reference work entry
  • First Online:
Reproduktionsmedizin

Part of the book series: Springer Reference Medizin ((SRM))

Zusammenfassung

Bei Patientinnen mit Kinderwunsch und habituellen Aborten sollte immer nach Uterusfehlbildungen gefahndet werden. Für die Klassifikation der Uterusfehlbildungen hat sich die AFS-Klassifikation bewährt. Die Kombination aus Hysteroskopie und Laparoskopie gilt als Goldstandard zur Diagnostik von Uterusfehlbildungen. Bei Uterusfehlbildungen ist immer nach assoziierten Fehlbildungen im Genitaltrakt (Vagina, Cervix) und Nieren- und Harnleiterfehlbildungen zu suchen. Beim Uterus unicornis mit einem nichtkommunizierenden Horn mit Endometrium ist eine laparoskopische Resektion zu empfehlen. Beim Uterus bicornis ist die Abort- und Frühgeburtenrate erhöht, sodass bei Patientinnen mit habituellen Aborten oder einer Hämatometra mit Beschwerden eine operative Korrektur notwendig ist (abdominale oder laparoskopische Metroplastik). Der Uterus subseptus ist die häufigste Fehlbildung. Es kann hier großzügig die Indikation zur Septumdissektion gestellt werden. Die Abortraten werden dadurch reduziert.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Similar content being viewed by others

Literatur

  • Akar ME, Bayar D, Yildiz S, Ozel M, Yilmaz Z (2005) Reproductive outcome of women with unicornuate uterus. Aust NZ J Obstet Gynaecol 45:148–150

    Article  Google Scholar 

  • Alborzi S, Asefjah H, Amini M, Vafaei H, Madadi G, Chubak N, Tavana Z (2015) Laparoscopic metroplasty in bicornuate and didelphic uteri: feasibility and outcome. Arch Gynecol Obstet 291:1167–1171

    Article  Google Scholar 

  • American Fertility Society – AFS (1988) The American Fertility Society classification of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Mullerian anomalies and intrauterine adhesions. Fertil Steril 49:944–955

    Article  Google Scholar 

  • Angell NF, Domingo J (2002) Uterine rupture at term after uncomplicated hysteroscopic metroplasty. Obstet Gynecol 100:1089–1099

    Google Scholar 

  • Appelman Z, Hazan Y, Hagay Z (2003) High prevalence of Müllerian anomalies diagnosed by ultrasound in women with polycystic ovaries. J Reprod Med 48:362–364

    PubMed  Google Scholar 

  • Aubriot FX, Chapron C (2007) Diethylstilbestrol exposure in utero. Polemics about metroplasty. The pros. Gynecol Obstet Fertil 35:826–831

    Article  Google Scholar 

  • Berkkanoglu M, Isikoglu M, Arici F, Ozgur K (2008) What is the best time to perform intracytoplasmic sperm injection/embryo transfer cycle after hysteroscopic surgery for an incomplete uterine septum? Fertil Steril 90:2112–2115

    Article  Google Scholar 

  • Bermejo C, Martinez-Ten P, Ruiz-Lopez L, Estevez M, Gil MM (2017) Classification of uterine anomalies by 3-dimensional ultrasonography using ESHRE/ESGE criteria: interobserver variability. Reprod Sci 1. https://doi.org/10.1177/1933719117725825

    Article  Google Scholar 

  • Bosteels J, Weyers S, D’Hooghe TM, Torrance H, Broekmans FJ, Chua SJ, Mol BWJ (2017) Anti-adhesion therapy following operative hysteroscopy for treatment of female subfertility. Cochrane Database Syst Rev 11:CD011110

    PubMed  Google Scholar 

  • Brännström M (2015) Uterus transplantation. Curr Opin Transplant 20:621–628

    Article  Google Scholar 

  • Braun P, Grau FV, Pons RM, Enguix DP (2005) Is hysterosalpingography able to diagnose all uterine malformations correctly? A retrospective study. Eur J Radiol 53:274–279

    PubMed  Google Scholar 

  • Brucker SY, Gegusch M, Zubke W, Rall K, Gauwerky JF, Wallwiener D (2008) Neovagina creation in vaginal agenesis: development of a new laparoscopic Vecchietti-based procedure and optimized instruments in a prospective comparative interventional study in 101 patients. Fertil Steril 90:1940–1952

    Article  Google Scholar 

  • Brucker SY, Brännström M, Taran FA, Nadalin S, Königsrainer A, Rall K, Schöller D, Henes M, Bösmüller H, Fend F, Nikolaou K, Notohamiprodjo M, Rosenberger P, Grasshoff C, Heim E, Krämer B, Reisenauer C, Hoopmann M, Kagan KO, Dahm-Kähler P, Kvarnström N, Wallwiener D (2017) Selecting living donors for uterus transplantation: lessons learned from two transplantations resulting in menstrual functionality and another attempt, aborted after organ retrieval. Arch Gynecol Obstet 21. https://doi.org/10.1007/s00404-017-4626-z. [Epub vor Druck]

    Article  Google Scholar 

  • Deutsche Gesellschaft für Gynäkologie und Geburtshilfe – DGGG (2010) Weibliche genitale Fehlbildungen. In: Leitlinien der Gynäkologie und Geburtshilfe, Bd I. S. Kramarz, Berlin, S 31–89

    Google Scholar 

  • Fukunaga T, Fujii S, Inoue C, Mukuda N, Murakami A, Tanabe Y, Harada T, Ogawa T (2017) The spectrum of imaging appearances of Müllerian duct anomalies: focus on MR imaging. Jpn J Radiol 35:697–706

    Article  Google Scholar 

  • Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P (2001) Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update 7:161–175

    Article  CAS  Google Scholar 

  • Grünberger W (2006) Operative Korrektur kongenitaler Fehlbildungen. Frauenarzt 47:2

    Google Scholar 

  • Heinonen PK (1982) Longitudinal vaginal septum. Eur J Obstet Gynecol Reprod Biol 13:253–258

    Article  CAS  Google Scholar 

  • Heinonen PK (2000) Clinical implications of the didelphic uterus: long-term follow-up of 49 cases. Eur J Obstet Gynecol Reprod Biol 91:183–190

    Article  CAS  Google Scholar 

  • Khalifa E, Toner JP, Jones HW Jr (1993) The role of abdominal metroplasty in the era of operative hysteroscopy. Surg Gynecol Obstet 176:208–212

    CAS  PubMed  Google Scholar 

  • Kupesse S, Kurjah A (1998) Septate uterus defection and prediction of obstetrical complication by different forms of ultrasonography. J Ultrasound Med 17:631–636

    Article  Google Scholar 

  • Ledig S, Tewes AC, Hucke J, Römer T, Kapczuk K, Schippert C, Hillemanns P, Wieacker P (2017) Array-CGH analysis in patients with Müllerian fusion anomalies. Clin Genet 25. https://doi.org/10.1111/cge.13160. [Epub vor Druck]

    Article  CAS  Google Scholar 

  • Ludwin A, Martins WP, Nastri CO, Ludwin I, Coelho Neto MA, Leitao VM, Acien M, Alcazar JL, Benacerraf B, Condous G, De Wilde RL, Emanuel MH, Gibbons W, Guerriero S, Hurd WW, Levine D, Lindheim S, Pellicer A, Petraglia F, Saridogan E (2018) Congenital Uterine Malformations by Experts (CUME): better criteria for distinguishing between normal/arcuate and septate uterus? Ultrasound Obstet Gynecol 51:101–109

    Article  CAS  Google Scholar 

  • Millischer AE, Grevent D, Rousseau V, O’Gorman N, Sonigo P, Bessieres B, Ville Y, Boddaert N, Salomon LJ (2017) Fetal MRI compared with ultrasound for the diagnosis of obstructive genital malformations. Prenat Diagn 37:1138–1145

    Article  CAS  Google Scholar 

  • Mollo A, De Franciscis P, Colacurci N, Cobellis L, Perino A, Venezia R, Alviggi C, De Placido G (2008) Hysteroscopic resection of the septum improves the pregnancy rate of women with unexplained infertility: a prospective controlled trial. Fertil Steril 91:2628–2631

    Article  Google Scholar 

  • Nahum GG (1998) Uterine anomalies. How common are they, and what is their distribution among subtypes? J Reprod Med 43:877–887

    CAS  PubMed  Google Scholar 

  • Nawroth F, Rahimi G, Nawroth C, Foth D, Ludwig M, Schmidt T (2006) Is there an association between septate uterus and endometriosis? Hum Reprod 21:542–544

    Article  Google Scholar 

  • Oppelt P, Renner SP, Brucker S, Strissel PL, Strick R, Oppelt PG, Doerr HG, Schott HG, Schott GE, Hucke J, Wallwiener D, Beckmann MW (2005) The VCUAM (Vagina Cervix Uterus Adnex-associeted Malformation) classification: a new classification for genital malformations. Fertil Steril 84:1493–1497

    Article  Google Scholar 

  • Oppelt P, von Have M, Paulsen M, Strissel PL, Strick R, Brucker S, Wallwiener D, Beckmann MW (2007) Female genital malformations and their associated abnormalities. Fertil Steril 87:335–342

    Article  Google Scholar 

  • Ozgur K, Bulut H, Berkkanoglu M, Coetzee K (2017) Reproductive outcomes of IVF patients with unicornuate uteri. Reprod Biomed Online 34:312–318

    Article  Google Scholar 

  • Prior M, Richardson A, Asif S, Polanski L, Parris-Larkin M, Chandler J, Fogg L, Jassal P, Thornton JG, Raine-Fenning NJ (2018) Outcome of assisted reproduction in women with congenital uterine anomalies: a prospective observational study. Ultrasound Obstet Gynecol 51:110–117

    Article  CAS  Google Scholar 

  • Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simón C, Pellicer A (1998) Reproductive impact of congenital Müllerian anomalies. Hum Reprod 12:2277–2281

    Article  Google Scholar 

  • Rikken JF, Kowalik CR, Emanuel MH, Mol BW, Van der Veen F, van Wely M, Goddijn M (2017) Septum resection for women of reproductive age with a septate uterus. Cochrane Database Syst Rev 1:CD008576

    PubMed  Google Scholar 

  • Römer T (2009) Operative Hysteroskopie, 2. Aufl. de Gruyter, Berlin

    Book  Google Scholar 

  • Römer T (2010) Uterine Fehlbildungen. In: Ludwig M (Hrsg) Gynäkologische Endokrinologie und Reproduktionsmedizin. Marseille, München, S 9–20

    Google Scholar 

  • Römer T (2011) Uterusfehlbildungen. de Gruyter, Berlin

    Book  Google Scholar 

  • Römer T, Lober R (1997) Hysteroscopic correction of a complete septate uterus using a balloon technique. Hum Reprod 12:478–479

    Article  Google Scholar 

  • Römer T, Schmidt T, Foth D (2000) Pre- and postoperative hormonal treatment in patients with hysteroscopic surgery. Contrib Gynecol Obstet 20:1–12

    Article  Google Scholar 

  • Rózewicki S, Bielewicz W, Iwanicki M, Puchalski A (1992) Developmental anomalies of the uterus in a population of 3000 women with various causes of infertility. Ginekol Pol 63:515–517

    PubMed  Google Scholar 

  • Saleem SN (2003) MR imaging diagnosis of uterovaginal anomalies: current state of the art. Radiographics 23:e13. Epub 2003 Jun 20

    Article  Google Scholar 

  • Saravelos SH, Cocksedge KA, Li TC (2008) Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod Update 14:415–429

    Article  Google Scholar 

  • Tewes AC, Rall KK, Römer T, Hucke J, Kapczuk K, Brucker S, Wieacker P, Ledig S (2015) Variations in RBM8A and TBX6 are associated with disorders of the Müllerian ducts. Fertil Steril 103:1313–1318

    Article  CAS  Google Scholar 

  • Tomazevic T, Ban-Frangez H, Ribic-Pucelj M, Premrusren T, Verdenik I (2007) Small uterine septum is an important risk variable for preterm birth. Eur J Obstet Gynecol Reprod Biol 135:154–157

    Article  CAS  Google Scholar 

  • Ugur M, Turan C, Mungan T, Kuscu E, Senöz S, Agis HT, Gökmen O (1995) Endometriosis in association with Müllerian anomalies. Gynecol Obstet Investig 40:261–264

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Gynäkologie und Geburtshilfe, Evangelisches Klinikum Köln-Weyertal, Köln, Deutschland

    Thomas Römer

  2. Facharzt-Zentrum für Kinderwunsch, Pränatale Medizin, Endokrinologie und Osteologie, amedes MVZ Hamburg, Hamburg, Deutschland

    Frank Nawroth

Authors
  1. Thomas Römer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frank Nawroth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas Römer .

Editor information

Editors and Affiliations

  1. Facharzt-Zentrum für Kinderwunsch, Pränatale Medizin, Endokrinologie und Osteologie Hamburg GmbH, amedes experts, Hamburg, Germany

    Klaus Diedrich

  2. SYNLAB Holding Deutschland GmbH, Augsburg, Hamburg, Germany

    Michael Ludwig

  3. Sektion für gynäkologische Endokrinologie und Reproduktionsmedizin, UNIVERSITÄTSKLINIKUM Schleswig-Holstein – Campus Lübeck, Lübeck, Schleswig-Holstein, Germany

    Georg Griesinger

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Römer, T., Nawroth, F. (2019). Uterine Fehlbildungen. In: Diedrich, K., Ludwig, M., Griesinger, G. (eds) Reproduktionsmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55601-6_37-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-55601-6_37-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-55601-6

  • Online ISBN: 978-3-662-55601-6

  • eBook Packages: Springer Referenz Medizin

Publish with us

Policies and ethics

Search

Navigation