Mullerian duct anomalies diagnosed by saline contrast sonohysterography: prevalence in a general population

作者：Dreisler Eva^*; Sorensen Soren Stampe

来源：Fertility and Sterility, 2014, 102(2): 525-529.

DOI：10.1016/j.fertnstert.2014.04.043

• Mullerian duct anomalies
• congenital uterine malformations
• saline contrast sonohysterography
• prevalence
• oligomenorrhea
• reproductive medicine
• miscarriage

Objective: To estimate the prevalence of uterine mullerian duct anomalies in a general population.
Design: Cross-sectional study.
Setting: University hospital in collaboration with the Danish Civil Registry.
Patient(s): A total of 1,654 women randomly recruited from a general population; 686 women were eligible and accepted inclusion (429 pre- and 257 postmenopausal). Saline contrast sonohysterography (SCSH) was finally performed in 622 women (aged 20-74 years) (the procedure was impossible owing to cervical stenosis in 58, contraindicated in 2, other patient-related factors in 4).
Intervention(s): The shape of the uterus was dynamically evaluated in the transversal and longitudinal planes during SCSH and classified in accordance with American Fertility Society as normal, arcuate, septate (partial, complete), bicorn (partial, complete), or unicorn. History of previous miscarriage and menstrual cycle was obtained by a questionnaire.
Main Outcome Measure(s): Prevalence of mullerian anomalies, miscarriage, and oligomenorrhea.
Result(s): The overall prevalence of mullerian anomalies was 9.8% (61 of 622) (95% confidence interval [CI] 7.5-12.1). The majority had arcuate uteri (n = 42, 6.8%), 17 partial septate (2.7%), 1 complete septate (1.6%), and 1 unicorn uterus (1.6%). Mullerian anomalies were significantly more frequently diagnosed in nulliparous (20% [26 of 128]) compared with parous women (7% [35 of 494]). Mullerian anomalies were more frequent in women with oligomenorrhea compared with women with normal menstrual periods (19% [15 of 79] vs. 10% [34 of 339]). One first-trimester miscarriage or multiple miscarriages (more than one) were not significantly more frequent in premenopausal women with mullerian anomalies compared with women with normal-shaped uteri (24% [6 of 25] vs. 22% [57 of 265]).
Conclusion(s): In a general population examined by SCSH the prevalence of Mullerian anomalies is estimated at 9.8%. Mullerian anomalies were more frequent in nulliparous women. Both impaired fertility and a pregnancy-associated modulation of the uterine corpus are among explanations. Mullerian anomalies were associated with oligomenorrhea in premenopausal women. In this general population there was no association between miscarriage and mullerian anomalies; however, the number of cases was limited.

• 出版日期2014-8