Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies
Open accessAbstract
The clinical implications of congenital uterine anomalies (CUA), and the benefits of hysteroscopic resection of a uterine septum, were evaluated. Studies comparing reproductive and obstetric outcome of patients with and without CUA and of patients who had and had not undergone hysteroscopic resection of a uterine septum, were evaluated. Meta-analysis of studies indicated that the pregnancy rate was decreased in women with CUA (RR 0.85, 95% CI 0.73 to 1.00; marginally significant finding, P = 0.05). The spontaneous abortion rate was increased in women with CUA (RR 1.68, 95% CI 1.31 to 2.15). Preterm delivery rates (RR 2.21, 95% CI 1.59 to 3.08), malpresentation at delivery (RR 4.75, 95% CI 3.29 to 6.84), low birth weight (RR 1.93, 95% CI 1.50 to 2.49) and perinatal mortality rates (RR 2.43, 95% CI 1.34 to 4.42) were significantly higher in women with CUA. Hysteroscopic removal of a septum was associated with a reduced probability of spontaneous abortion (RR 0.37, 95% CI 0.25 to 0.55) compared with untreated women. Presence of CUA might be associated with a detrimental effect on the probability of pregnancy achievement, spontaneous abortion and obstetric outcome. Hysteroscopic removal of a septum may reduce the probability of a spontaneous abortion.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In a population with recurrent miscarriage, the overall rate of subsequent miscarriage (first or second trimester) remained significantly increased 1.13 (1.06-1.22) compared with women with unexplained recurrent miscarriage.
“the overall rate of subsequent miscarriage (first or second trimester) remained significantly increased 1.13 (1.06-1.22)compared with women with unexplained recurrent miscarriage.62”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [62]
Table 2 reports a significantly increased combined first- and second-trimester miscarriage risk in women with congenital uterine anomalies who had experienced recurrent miscarriages (RR 1.13, 95% CI 1.06–1.22). The study descriptions list comparison groups with recurrent miscarriage and a normal uterus, but do not establish that all comparison cases were unexplained. (LLM, conf=0.84)
Experimental — accuracy not yet measuredWomen with septate (RR 2.65, 95% CI 1.39-5.06) and bicornuate uteri (RR 2.32, 95% CI 1.05-5.13) had a significantly increased risk of sporadic first trimester miscarriage versus normal controls.
“However, women with septate (RR 2.65, 95% CI 1.39-5.06;six studies) and bicornuate uteri (RR 2.32, 95% CI 1.05-5.13;four studies) had a significantly increased risk of sporadic first trimester miscarriage versus normal controls.62”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [62]
The First-trimester spontaneous abortion section reports the cited RRs and confidence intervals for septated and bicornuate uteri versus controls. It does not identify those estimates as specific to sporadic miscarriages; its population subgroup analysis also includes women with recurrent spontaneous abortions. The restriction to sporadic miscarriage is therefore unsupported. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWomen with arcuate (RR 1.98, 95% CI 1.06-3.69), septate (RR 2.95, 95% CI 1.51-5.77) and bicornuate uteri (RR 2.90, 95% CI 1.56-5.41) had a significantly increased risk of sporadic second trimester miscarriage versus controls.
“However, women with arcuate (RR 1.98, 95% CI 1.06-3.69;five studies), septate (RR 2.95, 95% CI 1.51-5.77;five studies) and bicornuate uteri (RR 2.90, 95% CI 1.56-5.41;four studies) had a significantly increased risk of sporadic second trimester miscarriage versus controls.62”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [62]
The Second-trimester spontaneous abortion section reports exactly the three relative risks, confidence intervals and study counts cited, with statistically significant increases versus controls. It measures spontaneous abortion, however, not specifically sporadic miscarriage; Table 2 includes a subgroup of women with recurrent spontaneous abortions. Page numbers are unavailable in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe risk of sporadic second trimester miscarriage was not significantly increased in women with didelphys (RR 1.71, 95% CI 0.63-4.59) and unicornuate uteri (RR 2.27, 95% CI 0.64-7.96) versus normal controls.
“The risk of sporadic second trimester miscarriage was not significantly increased in women with didelphys (RR 1.71, 95% CI 0.63-4.59;four studies) and unicornuate uteri (RR 2.27, 95% CI 0.64-7.96;four studies) versus normal controls.62”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [62]
The risk of sporadic first trimester miscarriage was not significantly increased in women with arcuate (RR 1.22, 95% CI 0.87-1.72), didelphys (RR 1.13, 95% CI 0.45-2.86) and unicornuate uteri (RR 1.38, 95% CI 0.83-2.28) versus normal controls.
“a meta-analysis has shown that the risk of sporadic first trimester miscarriage was not significantly increased in women with arcuate (RR 1.22, 95% CI 0.87-1.72;six studies), didelphys (RR 1.13, 95% CI 0.45-2.86;four studies) and unicornuate uteri (RR 1.38, 95% CI 0.83-2.28;five studies) versus normal controls.62”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [62]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552 · see citing works
(2014) · Medical Entomology and Zoology · Cited by 17,633 · see citing works
The American Fertility Society (1988) · Fertility and Sterility · doi:10.1016/s0015-0282(16)59942-7 · Cited by 1,847 · see citing works
Fertil, S. A. (1988) · Fertility and Sterility · Cited by 995 · see citing works
Clinical implications of uterine malformations and hysteroscopic treatment results
Grimbizis, G. (2001) · Human Reproduction Update · doi:10.1093/humupd/7.2.161 · Cited by 950 · see citing works
Self-citationThe ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies
Grimbizis, G. F., Gordts, S., Di Spiezio Sardo, A., Brucker, S., De Angelis, C., Gergolet, M., Li, T.-C., Tanos, V., Brolmann, H., Gianaroli, L., et al. (2013) · Human Reproduction · doi:10.1093/humrep/det098 · Cited by 884 · see citing works
Self-citationChan, Y. Y., Jayaprakasan, K., Zamora, J., Thornton, J. G., Raine-Fenning, N., & Coomarasamy, A. (2011) · Human Reproduction Update · doi:10.1093/humupd/dmr028 · Cited by 758 · see citing works
Saravelos, S. H., Cocksedge, K. A., & Li, T.-C. (2008) · Human Reproduction Update · doi:10.1093/humupd/dmn018 · Cited by 683 · see citing works
Müllerian Anomalies: A Proposed Classification (An Analysis of 144 Cases)
Buttram, V. C., & Gibbons, W. E. (1979) · Fertility and Sterility · doi:10.1016/s0015-0282(16)44114-2 · Cited by 595 · see citing works
Research designs for studies evaluating the effectiveness of change and improvement strategies
Eccles, M. (2003) · Quality and Safety in Health Care · doi:10.1136/qhc.12.1.47 · Cited by 586 · see citing works
Reproductive outcomes in women with congenital uterine anomalies: a systematic review
Chan, Y. Y., Jayaprakasan, K., Tan, A., Thornton, J. G., Coomarasamy, A., & Raine‐Fenning, N. J. (2011) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.10056 · Cited by 564 · see citing works
Reproductive performance of women with uterine malformations
Acién, P. (1993) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a137860 · Cited by 318 · see citing works
The ESHRE–ESGE consensus on the classification of female genital tract congenital anomalies
Grimbizis, G., Gordts, S., Sardo, A. D. S., Brucker, S. Y., Angelis, C. D., Gergolet, M., Li, T. C., Tanos, V., Brölmann, H. A. M., Gianaroli, L., et al. (2013) · Gynecological Surgery · doi:10.1007/s10397-013-0800-x · Cited by 246 · see citing works
Self-citationMollo, A., FRANCISCIS, P. D., Colacurci, N., Cobellis, L., Perino, A., Venezia, R., Alviggi, C., & Placido, G. D. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.04.011 · Cited by 244 · see citing works
Congenital uterine anomalies and adverse pregnancy outcomes
Hua, M., Odibo, A. O., Longman, R. E., Macones, G. A., Roehl, K. A., & Cahill, A. G. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2011.07.022 · Cited by 239 · see citing works
Müllerian anomalies and their management
Buttram, V. C. (1983) · Fertility and Sterility · doi:10.1016/s0015-0282(16)47230-4 · Cited by 230 · see citing works
Woelfer, B. (2001) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(01)01599-x · Cited by 226 · see citing works
Salim, R., Regan, L., Woelfer, B., Backos, M., & Jurkovic, D. (2003) · Human Reproduction · doi:10.1093/humrep/deg030 · Cited by 212 · see citing works
Pabuçcu, R., & Gomel, V. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.10.035 · Cited by 197 · see citing works
Reproductive prognosis after hysteroscopic metroplasty in 102 women: life-table analysis
Fedele, L., Arcaini, L., Parazzini, F., et al. (1993) · Fertility and Sterility · doi:10.1016/s0015-0282(16)55857-9 · Cited by 158 · see citing works
Hysteroscopic septum resection in patients with recurrent abortions or infertility
Grimbizis, G., Camus, M., Clasen, K., et al. (1998) · Human Reproduction · doi:10.1093/humrep/13.5.1188 · Cited by 146 · see citing works
Self-citationUltrastructural aspects of endometrium in infertile women with septate uterus
Fedele, L., Bianchi, S., Marchini, M., Franchi, D., Tozzi, L., & Dorta, M. (1996) · Fertility and Sterility · doi:10.1016/s0015-0282(16)58208-9 · Cited by 143 · see citing works
Septate, subseptate and arcuate uterus decrease pregnancy and live birth rates in IVF/ICSI
Tomaževič, T., Frangež, H. B., Virant‐Klun, I., et al. (2010) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2010.06.028 · Cited by 140 · see citing works
The role of HOX genes in human implantation
Taylor, H. S. (2000) · Human Reproduction Update · doi:10.1093/humupd/6.1.75 · Cited by 135 · see citing works
Hysteroscopic Treatment of the Septate Uterus
VALLE, R. F., & Sciarra, J. J. (1986) · Obstetrics and Gynecology · doi:10.1097/00006250-198602000-00017 · Cited by 134 · see citing works
Septate uterus: New idea on the histologic features of the septum in this abnormal uterus
Dabirashrafi, H., Bahadori, M., Mohammad, K., Alavi, M., Moghadami-Tabrizi, N., Zandinejad, K., & Ghafari, V. (1995) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(95)90093-4 · Cited by 116 · see citing works
Jarcho, J. (1946) · The American Journal of Surgery · doi:10.1016/0002-9610(46)90190-0 · Cited by 113 · see citing works
Jayaprakasan, K. M., Chan, Y., Sur, S. D., Deb, S., Clewes, J. S., & Raine‐Fenning, N. J. (2011) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.8968 · Cited by 112 · see citing works
Small uterine septum is an important risk variable for preterm birth
Tomaževič, T., Frangež, H. B., Ribič-Pucelj, M., Sršen, T. P., & Verdenik, I. (2006) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2006.12.001 · Cited by 110 · see citing works
Uterine anomalies and pregnancy outcome following resectoscope metroplasty
Zlopaša, G., Škrablin, S., Kalafatić, D., Banović, V., & Lešin, J. (2007) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2007.04.022 · Cited by 104 · see citing works
The pattern of pregnancy loss in women with congenital uterine anomalies and recurrent miscarriage
Saravelos, S. H., Cocksedge, K. A., & Li, T. C. (2009) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2009.11.021 · Cited by 92 · see citing works
Uterine anomalies and in vitro fertilization: what are the results?
Lavergne, N. A., Aristizabal, J., Zarka, V., et al. (1996) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/0301-2115(96)02459-1 · Cited by 83 · see citing works
Obstetric outcome of women with uterine anomalies in China.
Zhang, Y., Zhao, Y., & Qiao, J. (2010) · PubMed · Cited by 81 · see citing works
Hysteroscopy for metroplasty of uterine septa: report of 24 cases
Perino, A., Mencaglia, L., Hamou, J., et al. (1987) · Fertility and Sterility · doi:10.1016/s0015-0282(16)59364-9 · Cited by 78 · see citing works
Crocker, I. P., Wareing, M., Ferris, G. R., et al. (2005) · The Journal of Pathology · doi:10.1002/path.1801 · Cited by 75 · see citing works
Heinonen, P. K. (1997) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(05)80221-x · Cited by 74 · see citing works
Reproductive outcome after hysteroscopic metroplasty
Colacurci, N., Placido, G. D., Mollo, A., et al. (1996) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/0301-2115(96)02417-7 · Cited by 72 · see citing works
Hysteroscopic metroplasty in patients with a uterine septum and otherwise unexplained infertility
Tonguc, E. A., Var, T., & Batıoğlu, S. (2011) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2010.11.023 · Cited by 69 · see citing works
Frangež, H. B., Tomaževič, T., Virant‐Klun, I., et al. (2008) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2008.04.010 · Cited by 69 · see citing works
Ravasia, D. J., Brain, P. H., & Pollard, J. K. (1999) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(99)70318-2 · Cited by 68 · see citing works
Midline uterine defect size is correlated with miscarriage of euploid embryos in recurrent cases
Sugiura‐Ogasawara, M., Ozaki, Y., Kitaori, T., Kumagai, K., & Suzuki, S. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.12.097 · Cited by 64 · see citing works
Uterine anomalies. A retrospective, matched-control study.
Ben‐Rafael, Z., Seidman, D. S., Recabi, K., et al. (1991) · PubMed · Cited by 58 · see citing works
Hysteroscopic Metroplasty Improves Gestational Outcome in Women with Recurrent Spontaneous Abortion
Valli, E., Vaquero, E., Lazzarin, N., et al. (2004) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(05)60206-x · Cited by 57 · see citing works
Pregnancy and its outcome in women with malformed uterus.
Ma, S., Xuming, B., & Jinghe, L. (2002) · PubMed · Cited by 51 · see citing works
Hysteroscopic Treatment of Septate Uterus
Haberal, A., Batıoğlu, S., & Uğur, M. (1996) · Journal of Gynecologic Surgery · doi:10.1089/gyn.1996.12.241 · Cited by 46 · see citing works
Erez, O., Dukler, D., Novack, L., Rozen, A., Zolotnik, L., Bashiri, A., Koifman, A., & Mazor, M. (2007) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2007.01.012 · Cited by 41 · see citing works
Embryonic heart rate in early pregnancy
Stefos, T., Lolis, D. E., Sotiriadis, A., & Ziakas, G. (1998) · Journal of Clinical Ultrasound · doi:10.1002/(sici)1097-0096(199801)26:1 · Cited by 40 · see citing works
Not every subseptate uterus requires surgical correction to reduce poor reproductive outcome
Pang, L., Li, M., Li, M., et al. (2011) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2011.07.030 · Cited by 33 · see citing works
864: Congenital uterine anomalies and adverse pregnancy outcomes
Hua, M., Odibo, A. O., Longman, R. E., et al. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.10.947 · Cited by 33 · see citing works
Lin, K., Zhu, X., Xu, H., et al. (2008) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2008.11.018 · Cited by 27 · see citing works
Obstetric implications of minor müllerian anomalies in oligomenorrheic women
Sørensen, S. S., & Trauelsen, A. G. H. (1987) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(87)90121-9 · Cited by 25 · see citing works
Pregnancy complications and obstetric outcomes among women with congenital uterine malformations
Liang, F., & Hu, W. (2010) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2009.12.012 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Diagnosis and Management of Infertility: A Review
Carson, S. A., & Kallen, A. N. (2021) · JAMA · doi:10.1001/jama.2021.4788 · Cited by 1,294 · see citing works
The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies
Grimbizis, G. F., Di Spiezio Sardo, A., Saravelos, S. H., Gordts, S., Exacoustos, C., Van Schoubroeck, D., Bermejo, C., Amso, N. N., Nargund, G., Timmerman, D., et al. (2016) · Human Reproduction · doi:10.1093/humrep/dev264 · Cited by 232 · see citing works
Self-citationRecurrent MiscarriageGreen‐top Guideline No. 17
Regan, L., Rai, R., Saravelos, S., Li, T., & the Royal College of Obstetricians and Gynaecologists (2023) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17515 · Cited by 158 · see citing works
Épidémiologie et facteurs de risque de la prématurité
Torchin, H., & Ancel, P.-Y. (2016) · Journal de Gynécologie Obstétrique et Biologie de la Reproduction · doi:10.1016/j.jgyn.2016.09.013 · Cited by 134 · see citing works
Ludwin, A., Martins, W. P., Nastri, C. O., Ludwin, I., Coelho Neto, M. A., Leitão, V. M., Acién, M., Alcazar, J. L., Benacerraf, B., Condous, G., et al. (2018) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.18923 · Cited by 139 · see citing works
Prior, M., Richardson, A., Asif, S., Polanski, L., Parris‐Larkin, M., Chandler, J., Fogg, L., Jassal, P., Thornton, J. G., & Raine‐Fenning, N. J. (2018) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.18935 · Cited by 80 · see citing works
- Authors
- Venetis, C. A., Papadopoulos, S. P., Campo, R., Gordts, S., Tarlatzis, B. C., & Grimbizis, G. F.
- Affiliations
- Aristotle University of Thessaloniki (GR)
- The European Academy of Gynaecological Surgery (BE)
- Corresponding author
- Venetis, Christos A
- Venue
- Reproductive BioMedicine Online
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 29
- Issue
- 6
- Pages
- 665-683
- ISSN
- 1472-6483 (ISSN-L)
- OpenAlex
- W2165347830
- Cited by
- 332
- References
- 52
- Citations by year
- 2026: 22 · 2025: 31 · 2024: 30 · 2023: 32 · 2022: 35 · 2021: 50 · 2020: 51 · 2019: 21 · 2018: 13 · 2017: 22 · 2016: 14 · 2015: 9 · 2014: 2
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Reproductive BioMedicine Online (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Keywords
- congenital uterine anomalies, septate uterus, hysteroscopic resection, miscarriage, pregnancy rate, preterm birth, low birth weight, perinatal mortality, obstetric outcomes, reproductive outcomes
- MeSH terms
- Abortion, Spontaneous, Female, Humans, Pregnancy, Pregnancy Outcome, Urogenital Abnormalities, Uterus, Models, Statistical, Hysteroscopy, Risk Assessment, Premature Birth
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
