Surgical management of congenital uterine anomalies (Include indications and surgical techniques)

Publication date: Available online 15 February 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Theodoros D. Theodoridis, Panagiotis Pappas, Grigoris F. GrimbizisAbstractThe prevalence of congenital uterine anomalies (CUA) is reported to be 4,3-6,7% in the general population, 3,4-8% in the infertile population and 12,6-18,2% among those with recurrent miscarriages. They are the result of abnormal formation, differentiation and fusion of the Mu¨llerian or paramesonephric ducts during fetal life.Until now, various classification systems have been proposed for the categorization of Congenital Uterine Anomalies, but the recently introduced ESHRE/ESGE classification seems to be a new, clear and systematic categorization, which could be the substrate for the clinicians to rely on when they refer to congenital uterine anomalies and their clinical impact either generally or concerning pregnancy outcomes. CUA are apparently related with an impaired reproductive outcome, while their exact clinical impact as well as the effectiveness of their treatment is still considered controversial. Surgery is indicated in women presenting with symptoms related to specific uterine anomalies and especially in those with fertility problems. In this review, indications, surgical techniques for the repair of congenital uterine anomalies according to their classification as well as fertility and pregnancy outcomes before and after surgery will be thoroughly reviewed.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research