A unicornuate uterus, a rare congenital anomaly, is associated with a higher risk of certain obstetric and perinatal complications. This study examines reproductive outcomes in patients with this condition and compares them to those of infertile patients without Müllerian anomalies. Researchers conducted a retrospective analysis of data from infertile patients aged 18-40 diagnosed with a unicornuate uterus between January 2012 and December 2022. They compared these patients with a control group of age- and infertility duration-matched individuals without Müllerian anomalies.
The analysis included 75 patients with a unicornuate uterus and 75 controls. The unicornuate uterus group achieved 116 pregnancies, while the control group had 91. The study found significantly higher rates of ectopic pregnancy (10.3% vs. 2.2%, OR = 5.53, 95% CI [1.17–26.21]) and malpresentation (29% vs. 0%, OR = 1.40, 95% CI [1.12–1.76]) in the unicornuate uterus group. Additionally, newborns from this group had lower birth weights in singleton pregnancies (3,000 g vs. 3,455 g, p = 0.005). However, no significant differences were noted between the two groups in terms of live birth rates or preterm deliveries.
The study highlights that while a unicornuate uterus is a rare anomaly, it poses specific reproductive challenges, including increased risks of ectopic pregnancy, malpresentation, and reduced birth weights. Despite these risks, live birth rates and preterm delivery incidences were comparable to those of patients without Müllerian anomalies. These findings emphasize the need for comprehensive counseling and vigilant monitoring for patients with a unicornuate uterus throughout reproductive treatment and pregnancy.
