Impact of concomitant intrauterine adhesions on pregnancy outcomes and obstetric complications in women with a septate uterus

Objective To explore the impact of concomitant intrauterine adhesions (IUAs) on pregnancy outcomes and obstetric complications in women with a septate uterus. Methods This retrospective cohort included women with a septate uterus, with or without IUAs, between 2015 and 2019 in our hospital. The main outcomes were clinical pregnancy rate, live-birth rate, and obstetric complications. Results A total of 336 women with a septate uterus-105 women (31.3%) with IUAs and 231 (68.7%) women without IUAs-were analyzed. The rates of clinical pregnancy and live birth among women with moderate-to-severe IUAs were significantly decreased compared with those among women without IUAs (69.9% vs. 76.6%, odds ratio [OR] 0.51; 95% confidence interval [CI] 0.27-0.99, P = 0.046, and 57.0% vs. 67.1%, OR 0.53; 95% CI 0.30-0.95, P = 0.032, respectively). However, these rates were similar between women with mild IUAs and women without IUAs. Women with moderate-to-severe IUAs had a higher incidence of abnormal placentation than women with a septum only (13.2% vs. 1.3%, P = 0.001). Conclusion Concomitant moderate-to-severe IUAs significantly reduce the rates of clinical pregnancy and live birth and increase the risk of abnormal placentation in subsequent pregnancies in women with a septate uterus.

Automated summary

Concomitant intrauterine adhesions significantly reduce pregnancy rates and live birth rates, and increase the risk of abnormal placentation in women with a septate uterus.