Analysis of the reproductive outcomes and the size of the unicornuate uterus measured by magnetic resonance imaging and their relationship.

Abstract

To evaluate the relationship between the uterine size measured by pelvic magnetic resonance and reproductive outcome in women with a unicornuate uterus. This was a retrospective study including 140 patients affiliated with unicornuate uterus diagnosed by the pelvic MR prior to their first pregnancy in the Obstetrics and Gynecology Hospital of Fudan University from April 2010 to December 2017. All the length of the unicornuate uterus were re-measured and recorded by skilled radiologists during the study period. We divided all the 140 participants with complete pelvic MR imaging into four groups by the best reproductive outcomes, which refers to Group 1 (primary infertility, n = 21), Group 2 ( < 24weeks' gestation, n = 34), Group 3 (preterm delivery, 24-35weeks' gestation, n = 13), Group 4 ( ≥ 35weeks' gestation, n = 72), followed them up and then analyzed the data. Measurements of 140 patients with hemi-uteri were retrieved for analysis. The mean length of the uterine was 4.90 ±0.56cm. There were no significant differences in the uterine cavity length, cervical length, endometrial thickness and uterine wall thickness between the four groups while the uterine length (P=0.001) was statistically significant. Women with uterine lengths ≥ 4.5cm were more likely to experience full-term delivery compared with the other group (P=0.001). Ordinal multiple logistic regression analysis showed that the uterine length [OR=9.03 (95% CI: 2.90-28.13)] and uterine cavity length [OR=0.32 (95% CI: 0.06-2.04)] were independent protective factors for better obstetric outcomes CONCLUSION: The uterine length is a reliable prognostic factor for the gestational week of delivery and an appropriate antenatal surveillance factor of women with unicornuate uterus.