Uterine factors in recurrent pregnancy losses
Repeated pregnancy loss can result from uterine causes - congenital or acquired - and justify specific treatments in dedicated indications. In particular, these include septate uteri, intrauterine adhesions, endometrial polyps, and fibroids that extend into the uterine cavity
VOLUME 115, ISSUE 3, P538-545, MARCH 01, 2021
Marie Carbonnel, M.D., Paul Pirtea, M.D., Dominique de Ziegler, M.D., Jean Marc Ayoubi, M.D., Ph.D.
Congenital and acquired uterine anomalies are associated with recurrent pregnancy loss (RPL). Relevant congenital Müllerian tract anomalies include unicornuate, bicornuate septate, and arcuate uterus. Recurrent pregnancy loss has also been associated with acquired uterine abnormalities that distort the uterine cavity such as, notably, intrauterine adhesions, polyps, and submucosal myomas. Initial evaluation of women with RPLs should include an assessment of the uterine anatomy. Even if proof of efficacy of surgical management of certain uterine anomalies is often lacking for managing RPLs, surgery should be encouraged in certain circumstances for improving subsequent pregnancy outcome. Uterine anomalies such as uterine septa, endometrial polyps, intrauterine adhesions, and submucosal myomas are the primary surgical indications for managing RPLs.