Obstetric Outcome of the Malformed Uterus: Study of 155 Pregnancies

Background: Congenital uterine malformations result from abnormal development of the Müllerian ducts and are associated with adverse reproductive and obstetric outcomes. Data from eastern India regarding obstetric outcomes in women with uterine malformations are limited. Objectives: To study the types of congenital uterine malformations and evaluate their impact on obstetric and perinatal outcomes. Materials and Methods: This hospital-based prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Darbhanga Medical College and Hospital, Darbhanga, over a period of 12 months. A total of 155 pregnancies with confirmed congenital uterine malformations were included. Diagnosis was established using ultrasonography and magnetic resonance imaging where required. Data regarding demographic characteristics, obstetric history, antenatal complications, mode of delivery, and perinatal outcomes were collected and analyzed. Results: Septate uterus was the most common uterine anomaly (34.8%), followed by bicornuate uterus (27.1%). Miscarriage occurred in 13.5% of cases, and preterm delivery was observed in 20.6% of pregnancies. Malpresentation was present in 38.5% of cases. Cesarean section was performed in 67.2% of patients. Adverse perinatal outcomes included low birth weight in 35.2% and neonatal intensive care unit admission in 28.7% of live births. Septate and unicornuate uterus were associated with higher rates of adverse obstetric outcomes. Conclusion: Congenital uterine malformations significantly influence obstetric and perinatal outcomes. Early diagnosis, vigilant antenatal monitoring, and individualized management in a tertiary care setting are essential to improve pregnancy outcomes in women with uterine anomalies. Keywords: DMCH