Successful Reproductive Outcome Following Challenging Surgical Management of Mullerian Anomalies

Abstract

Background: Mullerian duct anomalies consist of a set of structural malforma-tions of reproductive organ resulting from abnormal development of the paramesonephric or Müllerian ducts. The prevalence of these anomalies ranges from 0.001 to 10% in the general population and from 8-10% in women with an adverse reproductive history. The aim of this study was to diagnose different type of mullerian anomalies and to evaluate the reproductive outcome that occurs as a result of surgical management of malformation of genital tract. Methods: A prospective observational study of mullarian anomalies and its diagnosis & reproductive outcome was observed by using data from women with congenital anomalies attended in OPD either with complains or incidental diagnosis with HSG,during laparoscopy at tertiary care center. Total 100 women with different types of mullarian anomalies were included in study. Results: Most common utero-vaginal anomaly seen in present study was septate uterus with on basis of clinical examination. Out of 100 patient (35)35% were diagnosed mullerian agenesis. Cervico vaginal agenesis (15)15%, Septate uterus 28(28%), Bicornaute uterus 7(7%), Transverse vaginal septum 5 % ,unicornuate 5%, Didelphi’s with longitudinal vaginal septum 2%, Microperforate Hymen 3(3%). Among all patients 26 patients were pregnant. Among primary amenorrhea 35 patient of mullarian agenesis after progressive non-surgical vaginal dilatation 22 patient had no coital difficulty. 5 patients were need vaginoplasty. Among 15 patients of cervicovaginal agenesis 6 become menstruating, 2 were pregnant, 6 patient failed anastomosis, needed total abdominal hysterectomy 3 patients on oral pill. Among 5 transverse vaginal septum, 5 having regular menestration among 2 become pregnant. Among other mullarian anamolies after challenging surgical management 22 patient become pregnant. Conclusion: Present study shows prevalence of congenital malformation of female reproductive tract is 0.83% at our .....