ABSTRACT
Anatomic uterine defects appear to predispose women to reproductive difficulties,
including first- and second-trimester pregnancy losses, higher rates of preterm labor
and birth, and abnormal fetal presentation. These anatomic abnormalities can be classified
as congenital, including müllerian and diethylstilbestrol-related abnormalities, or
acquired, such as intrauterine adhesions or leiomyomata. In women with three or more
consecutive spontaneous abortions who underwent hysterosalpingography or hysteroscopic
examination of their uteri, müllerian anomalies have been found in 8 to 10%. Women
with müllerian anomalies may be predisposed to recurrent pregnancy loss because of
inadequate vascularity to the developing embryo and placenta, reduced intraluminal
volume, or cervical incompetence. The reproductive history of most women with a müllerian
anomaly is poor, especially for women with a uterine septum, the most common müllerian
anomaly. Recurrent pregnancy losses resulting from a uterine septum, bicornuate uterus,
intrauterine adhesions, and fibroids are amenable to surgical correction. Women with
müllerian anomaly and a history of second-trimester pregnancy losses may benefit from
a prophylactic cervical cerclage.
KEYWORD
Recurrent pregnancy loss - müllerian anomalies - diethylstilbestrol
