Abstract
Congenital malformationsThe incidence of congenital uterine malformations in women with recurrent pregnancy loss is 13 %. An accurate and objective estimation of the uterus should be offered as soon as possible (particularly using a 3D sonography). The uterus septus or subseptus are the consequence of a defect in the absorption of the uterine septum. Pregnancy loss usually occurs in the late first trimester. A septum resection (metroplasty) by hysteroscopy is indicated, because the birth rate can be improved (> 80 %). In complicated malformations (unicornuate uterus, bicornuate, didelphys), advanced diagnostic imaging (MRI) is useful but surgical correction is normally not necessary, although the complication rate in late pregnancy remains high. Concomitant renal malformation should always be excluded (by ultrasound or MRI).Acquired pathologiesWhether the diagnosis and treatment of other uterine diseases (as fibroids, polyps, and adhesions) can reduce the risk of miscarriage is still controversial: surgical treatment is usually recommended.
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