ORIGINAL RESEARCH
Obstetrics and Gynecology
doi: 10.25005/2074-0581-2025-27-3-542-558
THE IMPACT OF CONGENITAL UTERINE ANOMALIES ON PREGNANCY OUTCOMES

SH.KH. IDIEVA, M.F. DODKHOEVA

Department of Obstetrics and Gynecology No. 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To study the course of pregnancy, childbirth, and perinatal outcomes in patients with various congenital uterine anomalies (CUAs)

Methods: A retrospective case-control study was conducted involving the maternity records of 232 patients, along with monitoring and examination of 97 gravidas with CUAs admitted to City Maternity Hospital No. 1 in Dushanbe, Republic of Tajikistan for delivery. Gravidas with CUAs formed the main group. Additionally, a control group was established, consisting of 38 healthy gravidas and puerperants. The study focused on examining the characteristics of pregnancy, labor, perinatal outcomes, and the morphological features of the placenta in gravidas with CUAs.

Results: The study found a high incidence of threatened miscarriage and premature birth among gravidas with CUAs. Both conditions resulted in spontaneous abortions in 7.2% of cases, non-viable pregnancies in 3.1%, and premature births in 11.8%. Additionally, there were elevated rates of chronic pyelonephritis recurrence alongside various other renal conditions throughout all three trimesters of pregnancy. From the second trimester onward, signs of intrauterine hypoxia and fetal growth retardation were observed. Ultrasound assessments confirmed these findings: intrauterine growth retardation was diagnosed in 12 patients (14.1%), and placental insufficiency was identified in 25 cases (29.4%). Unfortunately, there were four cases (4.7%) of antenatal mortality reported as well. The most common delivery complications were abnormal labor (35.3%), hypertensive disorders (23.5%), placental detachment (4.8%), two cases (2.3%) of threatened uterine rupture, and one case (1.2%) of uterine rupture. Breech presentation (27.1%) and fetal malposition (17.3%), along with complications during labor such as abnormal labor (35.3%), threatened uterine rupture, and uterine rupture, accounted for CS in 82.3% of cases. Among those with a bicornuate uterus, 78.5% of CS were performed as emergencies. Morphological studies showed pathological changes in all components of the placenta in women with CUAs.

Conclusion: he research findings revealed that CUAs have adverse effects throughout all stages of pregnancy and childbirth. These findings highlight the necessity for early diagnosis and thorough monitoring of gravidas, parturients, and puerperants with CUAs. It is essential to adopt a specialized approach to managing their pregnancies and preventing obstetric risks to improve outcomes and reduce both maternal and perinatal morbidity and mortality.

Keywords: Uterine anomalies, spontaneous miscarriage, intrauterine growth retardation, cesarean section (CS), placental insufficiencyy.

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References
  1. Akhapkina ES, Batyrova ZK, Chuprynin VD, Uvarova EV, Kumykova ZKh, Kruglyak DA. Osobennosti vedeniya devochek s anomaliyami razvitiya mochepolovoy sistemy [Peculiarities of management of girls with developmental anomalies of the genitourinary system]. Ginekologiya. 2021;23(3):245-9. https://doi.org /10.26442/20795696.2021.3.200951
  2. Batyrova ZK, Uvarova EV, Kumykova ZKh, Chuprynin VD, Kruglyak DA. Anomalii razvitiya polovykh organov s narusheniem ottoka menstrual'noy krovi: diagnostika, lechenie i profilaktika oslozhneniy [Anomalies in the development of the genital organs with impaired outflow of menstrual blood: Diagnosis, treatment and prevention of complications]. Pediatricheskaya farmakologiya. 2019;16(6):349-52. https://doi.org/10.15690/pf.v16i6.2072
  3. Ganti S, Laisram S, Katiyar A, Banerjee A, Gandhi A. Maternofetal outcomes in women with congenital uterine anomalies. Cureus. 2024;16(11):e73430. https://doi.org/10.7759/cureus.73430
  4. Rubakhova NN, Dyadichkina OV, Vasilieva LN. Sovremennye rekomendatsii po klassifikatsii, diagnostike i terapii vnutrimatochnoy peregorodki [Current recommendations for classification, diagnosis and therapy of intrauterine septum]. Okhrana materinstva i detstva. 2020;1:119-26.
  5. Jacquinet A, Millar D, Lehman A. Etiologies of uterine malformations. Am J Med Genet A. 2016;170(8):2141-72. https://doi.org/10.1002/ajmg.a.37775
  6. Wilson D, Bordoni B. Embryology, Mullerian Ducts (Paramesonephric Ducts). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. https:// pubmed.ncbi.nlm.nih.gov/32491659/ [Accessed 5th August 2025].
  7. Kim MA, Kim HS, Kim YH. Reproductive, obstetric and neonatal outcomes in women with congenital uterine anomalies: A systematic review and meta-analysis. J Clin Med. 2021;10(21):4797. https://doi.org/10.3390/jcm10214797
  8. Campo MC, Milán FP, Roig MC, Bartolomé EM, Arroyo JAD, Zambrano JLA, et al. Impact of congenital uterine anomalies on obstetric and perinatal outcomes: Systematic review and meta-analysis. Facts Views Vis ObGyn. 2024;16(1):9-22. https://doi.org/10.52054/FVVO.16.1.004
  9. Nam G, Lee SR. Congenital uterine anomaly and pelvic organ prolapse: A rare case of pelvic organ prolapse in a complete bicornuate uterus with successful pregnancy outcomes undiagnosed until the time of sacrocolpopexy. J Menopausal Med. 2021;27(1):32. https://doi.org/10.6118/jmm.21007
  10. Khazaei S, Jenabi E, Veisani Y. The association of Mullerian anomalies and placenta abruption: A meta-analysis. J Matern Fetal Neonatal Med. 2019;32(3):512-6. https://doi.org/10.1080/14767058.2017.1379072
  11. ahen-Peretz A, Sheiner E, Friger M, Walfisch A. The association between Müllerian anomalies and perinatal outcome. J Matern Fetal Neonatal Med. 2019;32(1):51-7. https://doi.org/10.1080/14767058.2017.1370703
  12. Lovelace D. Congenital uterine anomalies and uterine rupture. J Midwifery Womens Health. 2016;61(4):501-6. https://doi.org/10.1111/jmwh.12423
  13. Sultan S, Sabir SA, Liaqat N, Qazi Q. Obstetrical outcome in pregnant women presenting with congenital uterine anomalies. Pak J Med Sci. 2025;41(4):1078‑81. https://doi.org/10.12669/PJMS.41.4.10793
  14. Naeh A, Sigal E, Barda S, Hallak M, Gabbay‑Benziv R. The association between congenital uterine anomalies and perinatal outcomes – does type of defect matter? J Matern Fetal Neonatal Med. 2022;35(25):7406‑11. https://doi.org/1 0.1080/14767058.2021.1949446
  15. Turocy JM, Rackow BW. Uterine factor in recurrent pregnancy loss. Semin Perinatol. 2019;43(2):74‑9. https://doi.org/10.1053/j.semperi.2018.12.003
  16. Mandelbaum RS, Winer IS, Goffman D, Wisner DA, Childers ME, Sheth SS, et al. Obstetric outcomes of women with congenital uterine anomalies in the United States. Am J Obstet Gynecol MFM. 2024;6(8):101396. https://doi. org/10.1016/j.ajogmf.2024.101396
  17. Dekalo A, Feldstein O, Tal D, Friedman M, Schreiber L, Barda G, et al. The association of placental histopathological lesions and adverse obstetric outcomes in patients with Müllerian anomalies. Placenta. 2022;122:23-8. https:// doi:10.1016/j.placenta.2022.03.123
  18. Kazantseva EV, Tral TG, Tolibova GKh. Kliniko-anamnesticheskie dannye i morfofunktsional'nye osobennosti endometriya u zhenshchin s anomaliyami razvitiya matki [Clinical and anamnestic data and morphofunctional features of the endometrium in women with uterine developmental anomalies]. Zhurnal akusherstva i zhenskikh bolezney. 2021;70(2):5-12.
  19. Shchegolev AI. Current morphological classification of damages to the placenta. Obstetrics and Gynecology. 2016;4:16-23. https://doi.org/10.18565/ aig.2016.4.16-23

Authors' information:

Idieva Shakhzoda Khakimshoevna,
Postgraduate Student, Department of Obstetrics and Gynecology No. 1, Avicenna Tajik State Medical University
ORCID ID: 0009-0006-2848-3341
E-mail: shakhzoda.idieva@mail.ru

Dodkhoeva Munavvara Fayzulloevna,
Academician of the National Academy of Sciences of Tajikistan, Doctor of Medical Sciences, Full Professor, Professor of the Department of Obstetrics and Gynecology No. 1, Avicenna Tajik State Medical University
Researcher ID: AAC-4784-2019
ORCID ID: 0000-0001-9373-4318
SPIN: 9749-6174
Author ID: 313026
E-mail: dodkho2008@mail.ru

Information about support in the form of grants, equipment, medications

Academician of the National Academy of Sciences of Tajikistan, Doctor of Medical Sciences, Full Professor, Professor of the Department of Obstetrics and Gynecology No. 1, Avicenna Tajik State Medical University

Conflicts of interest: No conflict

Address for correspondence:

Dodkhoeva Munavvara Fayzulloevna
Academician of the National Academy of Sciences of Tajikistan, Doctor of Medical Sciences, Full Professor, Professor of the Department of Obstetrics and Gynecology No. 1, Avicenna Tajik State Medical University

734026, Republic of Tajikistan, Dushanbe, Sino str., 29-31

Tel.: +992 (918) 612606

E-mail: dodkho2008@mail.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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