UTERINE MALFORMATIONS AND PREGNANCY COMPLICATIONS
Keywords:uterine malformations, reproductive complications, USG-3D, surgical correction
The incidence of congenital uterine malformations is 3-5%. Often they lead to reproductive loss and other complications of pregnancy. The correct and timely diagnosis and surgical correction of abnormalities of the Müllerian duct is one of the important and rather difficult problems of contemporary gynecology. The purpose of the study was to evaluate the ultrasonographic (USG) criteria of uterine malformations and reproductive complications. In accordance with the purpose and objectives of the study, a retrospective study was carried out on a control group of 88 patients who underwent USG-3D and then the reproductive results were evaluated in the Obstetrics Service no. 1, 2, 3 of PMI MCH no. 1, during the 2016-2019 years. The study demonstrated the diagnostic importance in the evaluation of the α angle within the USG-3D, effectuated in 100% cases (Se-100%, Sp-100%), allowing correct diagnosis of uterine malformations and redirection, if necessary, to hysteroscopic or laparoscopic surgery. The efficacy of Jones surgery has been demonstrated in 5 patients (5,68%) with bicorn uterus in obtaining term birth. Both groups were found to have low reproductive results. The high incidence of caesarean operation was demonstrated in the studied groups, reaching 84,31% in the first group and 94.59% in the second, the found premature births being 12,51%, caused by premature rupture of the amniotic bag and the onset of premature labor. However, the incidence of severe preterm births is 2 times more frequent in the second group (septate uterus) and the Apgar score 2 times lower, respectively, caused by the vicious insertion of the placenta on the septum, found during cesarean surgery. The statistical difference of 2 times greater in the second lot and the septum insertion of the placenta demonstrate the need to widen the hysteroscopic surgery on the uterine septum.
Keywords: uterine malformations; reproductive complications; USG-3D; surgical correction.