Login Register Cart 0
Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Various Müllerian-duct Anomalies in Women at Rural Tertiary Care Center of Northern India: An Observational Study

Author(s): Naina Kumar* and Ashu Yadav

Volume 18, Issue 2, 2022

Published on: 02 March, 2021

Article ID: e241221191973 Pages: 8

DOI: 10.2174/1573404817666210302153013

Price: $65

Abstract

Aims: The present study was conducted to know presentations and nature of Müllerian- duct anomalies in rural women.

Background: Müllerian anomalies are congenital defects of female reproductive tract resulting from faulty development and fusion of Müllerian ducts. Objectives: To identify common Müllerian anomalies, their presentation, radiological appearances, complications, associated renal anomalies in rural women of Northern India.

Methods: Present observational study was conducted on 181 female patients with suspected Müllerian anomalies presenting to the outpatient department of Obstetrics and Gynecology with various complaints. Data included age, religion, menarche, previous pregnancy if any, duration of infertility, presenting complaints, type of Müllerian anomaly, incidental or symptomatic, diagnostic method, associated anomalies. Statistical analysis was done using SPSS 22.0 version software.

Results: Of 181 patients, 16.5% were adolescents, 83.5% adult women with an overall mean (SD) age of 25.02 (5.96) years. Of these, 170 had true Müllerian-duct anomalies and 11 had defects other than Müllerian anomalies, hence excluded. Total 158 (92.9%) patients were symptomatic and 12 (7.1%) asymptomatic at presentation. The majority (75.9%) were diagnosed incidentally during their visit to the department for various complaints of which infertility (32.4%) was most common. Septate uterus (29.4%) was most common anomaly diagnosed followed by Müllerian agenesis/hypoplasia (22.9%). Around 11.2% of cases had associated renal and collecting system anomalies with unilateral renal agenesis (47.4%) being most common.

Conclusion: Hence, Müllerian-duct anomalies have diverse presentations and most of them are diagnosed incidentally. The exact prevalence of Müllerian-duct anomalies may be high, especially in rural India, due to lack of knowledge and societal pressures.

Keywords: Amenorrhea, anomaly, infertility, Müllerian-duct, uterus, Müllerian agenesis.

Graphical Abstract

[1]
Hooda R, Malik N, Nanda S, Gupta A, Singhal SR, Dahiya K. Spectrum of Müllerian anomalies in emergency obstetrics: uunmasked at surgery–A 5-year analysis at a tertiary care teaching hospital. J Gynecol Surg 2018; 34(3): 138-43.
[http://dx.doi.org/10.1089/gyn.2017.0099]
[2]
Propst AM, Hill JA III. Anatomic factors associated with recurrent pregnancy loss. Semin Reprod Med 2000; 18(4): 341-50.
[http://dx.doi.org/10.1055/s-2000-13723] [PMID: 11355792]
[3]
Pui MH. Imaging diagnosis of congenital uterine malformation. Comput Med Imaging Graph 2004; 28(7): 425-33.
[http://dx.doi.org/10.1016/j.compmedimag.2004.05.008] [PMID: 15464882]
[4]
Golan A, Langer R, Bukovsky I, Caspi E. Congenital anomalies of the müllerian system. Fertil Steril 1989; 51(5): 747-55.
[http://dx.doi.org/10.1016/S0015-0282(16)60660-X] [PMID: 2651163]
[5]
Li S, Qayyum A, Coakley FV, Hricak H. Association of renal agenesis and mullerian duct anomalies. J Comput Assist Tomogr 2000; 24(6): 829-34.
[http://dx.doi.org/10.1097/00004728-200011000-00001] [PMID: 11105695]
[6]
Kapczuk K, Iwaniec K, Friebe Z, Kędzia W. Congenital malformations and other comorbidities in 125 women with Mayer-Rokitansky-Küster-Hauser syndrome. Eur J Obstet Gynecol Reprod Biol 2016; 207: 45-9.
[http://dx.doi.org/10.1016/j.ejogrb.2016.10.014] [PMID: 27825026]
[7]
Rall K, Eisenbeis S, Henninger V, et al. Typical and atypical associated findings in a group of 346 patients with Mayer-Rokitansky-Kuester-Hauser syndrome. J Pediatr Adolesc Gynecol 2015; 28(5): 362-8.
[http://dx.doi.org/10.1016/j.jpag.2014.07.019] [PMID: 26148785]
[8]
de Groot JA, Tierney Wolgemuth BS, Sanfilippo J. Müllerian anomalies in the pediatric and adolescent population: diagnosis, counseling and treatment options. Ann Infert Rep Endocrin 2019; 2(1): 1016.
[9]
The american fertility society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil Steril 1988; 49(6): 944-55.
[http://dx.doi.org/10.1016/S0015-0282(16)59942-7] [PMID: 3371491]
[10]
Committee on adolescent health care. ACOG committee opinion No. 728: Müllerian agenesis: Diagnosis, management and treatment. Obstet Gynecol 2018; 131(1): e35-42.
[http://dx.doi.org/10.1097/AOG.0000000000002458] [PMID: 29266078]
[11]
Acién P, Acién M. The presentation and management of complex female genital malformations. Hum Reprod Update 2016; 22(1): 48-69.
[http://dx.doi.org/10.1093/humupd/dmv048] [PMID: 26537987]
[12]
Fox NS, Roman AS, Stern EM, Gerber RS, Saltzman DH, Rebarber A. Type of congenital uterine anomaly and adverse pregnancy outcomes. J Matern Fetal Neonatal Med 2014; 27(9): 949-53.
[http://dx.doi.org/10.3109/14767058.2013.847082] [PMID: 24050215]
[13]
Practice committee of the American society for reproductive medicine. Current evaluation of amenorrhea. Fertil Steril 2006; 86(5)(Suppl. 1): S148-55.
[http://dx.doi.org/10.1016/j.fertnstert.2006.08.013] [PMID: 17055812]
[14]
Latthe PM, Champaneria R, Khan KS. Dysmenorrhoea. BMJ Clin Evid 2011; 2011: 0813.
[15]
Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clin Biochem 2018; 62: 2-10.
[http://dx.doi.org/10.1016/j.clinbiochem.2018.03.012] [PMID: 29555319]
[16]
Regan L, Backos M, Rai R. Recurrent Miscarriage, Investigation and Treatment of Couples (Green-top Guideline No. 17). Royal College of Obstetricians and Gynaecologists, 2011. Available from: https://www.rcog.org.uk/en/guidelines-research-services/ guidelines/gtg17/
[17]
American college of obstetricians and gynecologists revitalize (2018) Gynecology data definitions (version 1.0). Available at: https://www.acog.org/-/media/Departments/ Patient-Safety-and-Quality- Improvement/reVITALize-Gynecology-Definitions-V2.pdf
[18]
Gurtcheff S, Hatasaka H, Lambert P, Empey R, Morris E, Hammoud A. Clinical presentation of Müllerian anomalies in a large population cohort. Fertil Steril 2008; 90: S153-4.
[http://dx.doi.org/10.1016/j.fertnstert.2008.07.294]
[19]
Reyes-Muñoz E, Vitale SG, Alvarado-Rosales D, et al. Müllerian anomalies prevalence diagnosed by hysteroscopy and laparoscopy in Mexican infertile women: Results from a cohort study. Diagnostics (Basel) 2019; 9(4): E149.
[http://dx.doi.org/10.3390/diagnostics9040149] [PMID: 31627332]
[20]
Agarwal M, Bhushan D, Agarwal N, Singh S. The spectrum of Müllerian anomalies presented in a tertiary care centre: Three-year experience. J Genit Syst Disord 2019; 8: 1.
[21]
Mazouni C, Girard G, Deter R, Haumonte JB, Blanc B, Bretelle F. Diagnosis of Mullerian anomalies in adults: evaluation of practice. Fertil Steril 2008; 89(1): 219-22.
[http://dx.doi.org/10.1016/j.fertnstert.2007.02.044] [PMID: 17482176]
[22]
Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update 2011; 17(6): 761-71.
[http://dx.doi.org/10.1093/humupd/dmr028] [PMID: 21705770]
[23]
Rackow BW, Arici A. Reproductive performance of women with müllerian anomalies. Curr Opin Obstet Gynecol 2007; 19(3): 229-37.
[http://dx.doi.org/10.1097/GCO.0b013e32814b0649] [PMID: 17495638]
[24]
Laganà AS, Garzon S, Götte M, et al. The pathogenesis of endometriosis: Molecular and cell biology insights. Int J Mol Sci 2019; 20(22): 5615.
[http://dx.doi.org/10.3390/ijms20225615] [PMID: 31717614]
[25]
Maniglio P, Ricciardi E, Laganà AS, Triolo O, Caserta D. Epigenetic modifications of primordial reproductive tract: A common etiologic pathway for Mayer-Rokitansky-Kuster-Hauser Syndrome and endometriosis? Med Hypotheses 2016; 90: 4-5.
[http://dx.doi.org/10.1016/j.mehy.2016.02.015] [PMID: 27063075]
[26]
Freytag D, Mettler L, Maass N, Günther V, Alkatout I. Uterine anomalies and endometriosis. Minerva Med 2020; 111(1): 33-49.
[http://dx.doi.org/10.23736/S0026-4806.19.06341-9] [PMID: 31755672]
[27]
Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update 2001; 7(2): 161-74.
[http://dx.doi.org/10.1093/humupd/7.2.161] [PMID: 11284660]
[28]
Ajayi A, Ajayi V, Biobaku O, et al. Pattern of congenital uterine anomalies among infertile women in southwest nigeria. J Minim Invasive Gynecol 2015; 22(6S): S158.
[http://dx.doi.org/10.1016/j.jmig.2015.08.596] [PMID: 27678894]
[29]
Taylor E, Gomel V. The uterus and fertility. Fertil Steril 2008; 89(1): 1-16.
[http://dx.doi.org/10.1016/j.fertnstert.2007.09.069] [PMID: 18155200]
[30]
Troiano RN, McCarthy SM. Mullerian duct anomalies: Imaging and clinical issues. Radiology 2004; 233(1): 19-34.
[http://dx.doi.org/10.1148/radiol.2331020777] [PMID: 15317956]
[31]
Hall-Craggs MA, Kirkham A, Creighton SM. Renal and urological abnormalities occurring with Mullerian anomalies. J Pediatr Urol 2013; 9(1): 27-32.
[http://dx.doi.org/10.1016/j.jpurol.2011.11.003] [PMID: 22129802]
[32]
Heinonen PK. Renal tract malformations associated with Müllerian duct anomalies. Clin Obstet Gynecol Reprod Med 2018; 4(1): 1-5.
[http://dx.doi.org/10.15761/COGRM.1000207]
[33]
Broughton DE, Anderson K, Jungheim E, Siegel C. The incidence of renal anomalies in patients with septate uteri. Fertil Steril 2016; 106(3): e15.
[http://dx.doi.org/10.1016/j.fertnstert.2016.07.051]

Rights & Permissions Print Cite
Article Metrics
14
1
© 2024 Bentham Science Publishers | Privacy Policy