HYSTEROSCOPICALLY DETECTED ASYMPTOMATIC MULLERIAN ANOMALIES - PREVALENCE AND REPRODUCTIVE IMPLICATIONS

OBJECTIVE: To assess the prevalence of uterine anomalies and relative reproductive function in 322 women with abnormal uterine bleeding (AUB ) evaluated by diagnostic hysteroscopy. STUDY DESIGN: Uterine contours were classified as septate/bicornuate, arcuate or normal on the basis of hysteroscopy. A complete medical history was obtained from all the subjects; it included a questionnaire on menstrual characteristics, r eproductive history and pregnancy outcome. Cumulative birth rates, fre quency of spontaneous abortion, preterm delivery, malpresentation and mode of delivery in patients with normal and abnormal uteri were compa red using, life table analysis, the log-rank test and chi(2) analysis. RESULTS: Arcuate, septate/bicornuate and unicornuate uteri were obser ved in 6.5%, 3.7% and 0.3% of women, respectively. Although 24-month p regnancy rates and monthly fecundability rates were similar in women w ith and without mullerian anomalies, the 36-month cumulative live birt h rate was significantly lower in women with a septate/bicornuate uter us. Overall, women with uterine malformations showed a significantly h igher miscarriage rate (P < .05) and a significantly lower term delive ry rate (P < .05) than women with 17 normal-shaped uterus. CONCLUSION: Diagnostic hysteroscopy in women with AUB detected a 10% prevalence o f uterine anomalies, which were associated with a significantly higher incidence of spontaneous abortion and lower cumulative live birth rat es.