Abstract
Abstract
Objectives:
The goals of this study were to: (1) scrutinize cases of Müllerian anomalies (MuAs) diagnosed intraoperatively, for the first time, during emergency operations: (2) categorize the various MuAs; and (3) compare the presentations of the different subclasses.
Materials and Methods:
For this retrospective cohort study, the records of all the obstetric surgeries performed in the emergency operation theater of the Pt. B. D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India, were examined from January 2012 to May 2017. All the cases for which MuAs were identified intraoperatively were noted and classified according to the latest ESHRE/ESGE Classification. The MuA classes and subclasses were analyzed in terms of reproductive characteristics, perinatal complications, and association with past adverse outcomes.
Results:
A total of 12,935 emergency obstetric surgeries were performed, and the prevalence of MuAs was 1.3%. The most frequent MuA subtype encountered was hemiuterus at 57.4% (class U4). There was a significant difference in the rate of preterm deliveries and preterm premature rupture of membranes in the index pregnancies between these classes (p = 0.002 and p < 0.0001, respectively). Furthermore, the various classes differed significantly in associated malpresentations; Classes U1 and U2 were least associated with breech (p = 0.001) presentations but were most associated with transverse lie (p < 0.0001). Life-threatening conditions were significantly higher in patients with class U4a undergoing laparotomy than cesarean sections (p < 0.0001).
Conclusions:
MuAs, although often associated with benign conditions, can present as catastrophic obstetric events. Timely diagnosis and rectification of certain malformations, especially class U4a, is essential and lifesaving. (J GYNECOL SURG 34:138)
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