The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review

By Y. Chan, K. Jayaprakasan, J. Zamora, J. Thornton, N. Raine-Fenning, A. Coomarasamy. Human Reproduction Update, 2011

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BACKGROUND The prevalence of congenital uterine anomalies in high-risk women is unclear, as several different diagnostic approaches have been applied to different groups of patients. This review aims to evaluate the prevalence of such anomalies in unselected populations and in women with infertility, including those undergoing IVF treatment, women with a history of miscarriage, women with infertility and recurrent miscarriage combined, and women with a history of preterm delivery. METHODS Searches of MEDLINE, EMBASE, Web of Science and the Cochrane register were performed. Study selection and data extraction were conducted independently by two reviewers. Studies were grouped into those that used ‘optimal’ and ‘suboptimal’ tests for uterine anomalies. Meta-analyses were performed to establish the prevalence of uterine anomalies and their subtypes within the various populations. RESULTS We identified 94 observational studies comprising 89 861 women. The prevalence of uterine anomalies diagnosed by optimal tests was 5.5% [95% confidence interval (CI), 3.5–8.5] in the unselected population, 8.0% (95% CI, 5.3–12) in infertile women, 13.3% (95% CI, 8.9–20.0) in those with a history of miscarriage and 24.5% (95% CI, 18.3–32.8) in those with miscarriage and infertility. Arcuate uterus is most common in the unselected population (3.9%; 95% CI, 2.1–7.1), and its prevalence is not increased in high-risk groups. In contrast, septate uterus is the most common anomaly in high-risk populations. CONCLUSIONS Women with a history of miscarriage or miscarriage and infertility have higher prevalence of congenital uterine anomalies compared with the unselected population.

Subfields: Obstetrics and Gynecology, Surgery, Transplantation

View Paper: https://www.semanticscholar.org/paper/89059377b9f51da2a7ba29ef4c73fbc3e4cd10e6

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Citations in the corpus

The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies, (2013, neutral): “They represent a rather common benign condition with a prevalence of 4–7% (Grimbizis et al., 2001; Saravelos et al., 2008; Chan et al., 2011a).”
ESHRE guideline: recurrent pregnancy loss (2018, background): “Conditional ⊕⊕○○ MRI is not recommended as first line option for the assessment of uterine malformations in women with RPL, but can be used where 3D ultrasound (3D US) is not available (Oppelt et al., 2007; Saravelos et al., 2008; Chan et al., 2011b).”