Spectrum of Müllerian Anomalies in Emergency Obstetrics: Unmasked at Surgery–A 5-Year Analysis at a Tertiary Care Teaching Hospital.

<italic>Objectives:</italic> The goals of this study were to: (1) scrutinize cases of Müllerian anomalies (MuAs) diagnosed intraoperatively, for the first time, during emergency operations: (2) categorize the various MuAs; and (3) compare the presentations of the different subclasses. <italic>Materi...

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Publicado en:Journal of Gynecologic Surgery Vol. 34; no. 3; pp. 138 - 144
Autores principales: Hooda, Reetu, Malik, Nisha, Nanda, Smiti, Gupta, Anjali, Singhal, Savita Rani, Dahiya, Krishna
Formato: pictorial research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Jun2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2018
      vid: 34
      iid: 3
      pid: 1365
      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        129770773
        129770773
        129770773
        10.1089/gyn.2017.0099
        129770773
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        atl: Spectrum of Müllerian Anomalies in Emergency Obstetrics: Unmasked at Surgery–A 5-Year Analysis at a Tertiary Care Teaching Hospital.
      aug:
        au:
          Hooda, Reetu
          Malik, Nisha
          Nanda, Smiti
          Gupta, Anjali
          Singhal, Savita Rani
          Dahiya, Krishna
        affil: Department of Obstetrics and Gynaecology, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
      sug:
        subj:
          Tertiary Health Care
          Surgery, Obstetrical
          Obstetric Emergencies
          Uterus Abnormalities
          Uterus Surgery
          Human
          Academic Medical Centers
          Retrospective Design
          Prospective Studies
          India
          Prevalence
          Childbirth, Premature
          Pregnancy
          Female
          Laparotomy
          Cesarean Section
          Female
      ab: <italic>Objectives:</italic> The goals of this study were to: (1) scrutinize cases of Müllerian anomalies (MuAs) diagnosed intraoperatively, for the first time, during emergency operations: (2) categorize the various MuAs; and (3) compare the presentations of the different subclasses. <italic>Materials and Methods:</italic> For this retrospective cohort study, the records of all the obstetric surgeries performed in the emergency operation theater of the Pt. B. D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India, were examined from January 2012 to May 2017. All the cases for which MuAs were identified intraoperatively were noted and classified according to the latest ESHRE/ESGE Classification. The MuA classes and subclasses were analyzed in terms of reproductive characteristics, perinatal complications, and association with past adverse outcomes. <italic>Results:</italic> A total of 12,935 emergency obstetric surgeries were performed, and the prevalence of MuAs was 1.3%. The most frequent MuA subtype encountered was hemiuterus at 57.4% (class U4). There was a significant difference in the rate of preterm deliveries and preterm premature rupture of membranes in the index pregnancies between these classes (<italic>p</italic> = 0.002 and <italic>p</italic> < 0.0001, respectively). Furthermore, the various classes differed significantly in associated malpresentations; Classes U1 and U2 were least associated with breech (<italic>p</italic> = 0.001) presentations but were most associated with transverse lie (<italic>p</italic> < 0.0001). Life-threatening conditions were significantly higher in patients with class U4a undergoing laparotomy than cesarean sections (<italic>p</italic> < 0.0001). <italic>Conclusions:</italic> MuAs, although often associated with benign conditions, can present as catastrophic obstetric events. Timely diagnosis and rectification of certain malformations, especially class U4a, is essential and lifesaving. (J GYNECOL SURG 34:138)
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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