Journal List > Korean J Obstet Gynecol > v.53(7) > 1006442

Jeon, Park, Shin, Kim, Chae, Kim, and Kang: Clinical characteristics of women with Müllerian anomaly: Twenty years of experience at Asan Medical Center

Abstract

Objective

To investigate the clinical characteristics and reproductive outcomes of women with Müllerian anomalies.

Methods

One hundred and eighty-six patients were diagnosed with Müllerian anomalies at the Asan Medical Center from 1990 to 2009 and their clinical characteristics and reproductive outcomes were analyzed. Müllerian anomalies were categorized according to the classification by the American Fertility Society (1988).

Results

Müllerian anomaly was noticed in 1 in 1,326 patients (0.075%). Most cases were found in adulthood (84.9%) whereas only 15.1% cases in adolescent or pediatric period. More than 40% of cases were asymptomatic and found incidentally but others suffered from amenorrhea (12.4%), dysmenorrhea (10.8%), abnormal menstruation (10.2%), etc. Most common type of uterine anomalies was uterine didelphys (30.6%), followed by bicornuate uterus (19.4%), Mayer-Rokitansky-Küster-Hauser syndrome (10.8%), septate uterus (9.1%) and unicornuate uterus (8.6%). On the reproductive outcomes of 251 pregnancies identified, spontaneous miscarriages and preterm labor were quite common (55.8%), and the overall live birth rate was 48.6%. When each anomaly was individually analyzed, the live birth rate was 60.0% in the arcuate uterus and 58.0% in the uterine didelphys. The unicornuate and bicornuate uterus presented a similar chance of having a living child (42.1%, 46.7%), while the septate uterus showed a relatively lower live birth rate (32.4%).

Conclusion

Although most cases of Müllerian anomalies are diagnosed in adulthood, many patients may suffer from menstrual abnormalities, dysmenorrhea or recurrent miscarriages since adolescence. The reproductive outcomes of the arcuate uterus and uterine didelphys were better, while those of septate uterus were poor in our study.

Figures and Tables

Fig. 1
American Fertility Society (AFS) classification system for Müllerian anomalies (1988). DES: diethylstilbestrol.
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Fig. 2
Diagnostic timing in Müllerian anomalies.
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Table 1
Type and incidence of Müllerian anomalies
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*American Fertility Society (1988).

Mayer-Rokitansky-Küster-Hauser syndrome.

Diethylstilbestrol.

Table 2
Diagnostic methods for the Müllerian anomalies
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Table 3
Chief complaints in patients with Müllerian anomalies
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Table 4
Operation in Müllerian anomalies
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Table 5
Reproductive performance of patients with uterine anomalies
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