Placental Location and Reproductive Outcome in Patients With Uterine Septum or Arcuate Uterus [19G

Abstract

INTRODUCTION: The aim of this study is to determine placental location in pregnancy that ended in a live birth in patients with known uterine septum or arcuate uterine anomaly. METHODS: This retrospective study included sixty-seven patients who had a live birth and a diagnosis of uterine septum or arcuate uterine anomaly based on trans-vaginal 3D ultrasound scan (TV 3D US) with or without saline infusion sonohysterogram (SIH) between 2005 and 2015. Thirty patients (44.8%) presented with secondary infertility, 6 patients (9%) presented with recurrent pregnancy loss (RPL), 3 patients (4.5%) presented with history of miscarriage, and 28 (41.8%) presented with secondary infertility and miscarriage or RPL. RESULTS: Mean age was 32.4±4.3 years. Mean gestational age was 37.1±3.9 weeks. Placental location was not on the septum in 57 patients (85.1%); placental location was anterior in 29 patients (43.3%), posterior in 25 patients (37.3%), and lateral in 3 patients (4.5%). Eight patients (11.9%) had partial fundal location (fundal anterior in 6 patients [75%], and fundal posterior in 2 patients [25%]). Placental location was fundal in 2 patients (3%). In one of these patients the septum was found to be very vascular during hysteroscopy; the patient experienced vaginal bleeding through the pregnancy and delivered at 28 weeks. CONCLUSION: Our data support the long held theory that placental location in relation to uterine septum or arcuate uterine anomaly influence reproductive outcomes. Also, our data may explain the variable reproductive outcome of patients with such anomalies in the literature.