Reply

Abstract

We thank Drs Matsushita, Ogawa, and Matsuda for their interest in our article.1Hua M. Odibo A.O. Longman R.E. Macones G.A. Roehl K.A. Cahill A.G. Congenital uterine anomalies and adverse pregnancy outcomes.Am J Obstet Gynecol. 2011; 205: 558.e1-558.e5Abstract Full Text Full Text PDF Scopus (97) Google Scholar In their letter to the editor, they requested clarification regarding the diagnosis of uterine anomalies. The anomalies were diagnosed during the routine anatomy ultrasound, which is a 2-dimensional ultrasound that occurs typically in the second trimester. The words “routine anatomic survey” and “anatomy ultrasound” are used interchangeably throughout the manuscript.Dr Matsushita et al also note that the incidence of uterine anomalies was lower in our cohort compared to other published studies. We agree with Dr Matsushita et al that the method of diagnosis likely contributes to the discrepancy. We acknowledge that ultrasound is not the most sensitive method to diagnose uterine anomalies. However, we believe that the consequence of this is that uterine anomalies are underdiagnosed in our control population, thus biasing our results toward the null.Dr Matsushita et al are correct that there is a typo in the “Results” section and we appreciate the opportunity to clarify it. The statement should read: “while uterine didelphys accounts for only 25% of the uterine anomalies, they had a higher proportion of preterm birth <34 weeks and <37 weeks than any other subgroup.”Lastly, Dr Matsushita et al request that we recommend an ideal method of diagnosing a uterine anomaly. Methods cited in the letter to the editors include hysterosalpingogram, sonohysterography, laparoscopy, and magnetic resonance imaging; however, these studies are not routinely performed on pregnant women. We regret that our study does not further clarify methods of diagnosing uterine anomalies. Our study's aim was not to investigate imaging modality but rather to provide data regarding pregnancy outcomes for fertile women in whom uterine anomalies are diagnosed during the second trimester of pregnancy. We thank Drs Matsushita, Ogawa, and Matsuda for their interest in our article.1Hua M. Odibo A.O. Longman R.E. Macones G.A. Roehl K.A. Cahill A.G. Congenital uterine anomalies and adverse pregnancy outcomes.Am J Obstet Gynecol. 2011; 205: 558.e1-558.e5Abstract Full Text Full Text PDF Scopus (97) Google Scholar In their letter to the editor, they requested clarification regarding the diagnosis of uterine anomalies. The anomalies were diagnosed during the routine anatomy ultrasound, which is a 2-dimensional ultrasound that occurs typically in the second trimester. The words “routine anatomic survey” and “anatomy ultrasound” are used interchangeably throughout the manuscript. Dr Matsushita et al also note that the incidence of uterine anomalies was lower in our cohort compared to other published studies. We agree with Dr Matsushita et al that the method of diagnosis likely contributes to the discrepancy. We acknowledge that ultrasound is not the most sensitive method to diagnose uterine anomalies. However, we believe that the consequence of this is that uterine anomalies are underdiagnosed in our control population, thus biasing our results toward the null. Dr Matsushita et al are correct that there is a typo in the “Results” section and we appreciate the opportunity to clarify it. The statement should read: “while uterine didelphys accounts for only 25% of the uterine anomalies, they had a higher proportion of preterm birth <34 weeks and <37 weeks than any other subgroup.” Lastly, Dr Matsushita et al request that we recommend an ideal method of diagnosing a uterine anomaly. Methods cited in the letter to the editors include hysterosalpingogram, sonohysterography, laparoscopy, and magnetic resonance imaging; however, these studies are not routinely performed on pregnant women. We regret that our study does not further clarify methods of diagnosing uterine anomalies. Our study's aim was not to investigate imaging modality but rather to provide data regarding pregnancy outcomes for fertile women in whom uterine anomalies are diagnosed during the second trimester of pregnancy. Pregnant uterine anomalies may be difficult to diagnose only by 2-dimensional ultrasoundAmerican Journal of Obstetrics & GynecologyVol. 207Issue 4PreviewWe read with great interest the article titled “Congenital uterine anomalies and adverse pregnancy outcomes” by Meiling Hua et al1 (2011). However, the article contains a section that may not be correct regarding the incidence of preterm births <37 weeks by uterine anomalies, which requires the authors' attention. And the article also has some confusing presentation in the “Materials and Methods,” “Results,” and “Comment” sections concerning the diagnosis of uterine anomalies. Full-Text PDF