Uterine factor in recurrent pregnancy loss

Semin Perinatol. 2019 Mar;43(2):74-79. doi: 10.1053/j.semperi.2018.12.003. Epub 2018 Dec 20.

Abstract

Objective: To review the current understanding of the role the uterus plays in recurrent pregnancy loss.

Findings: Congenital and acquired uterine abnormalities are associated with recurrent pregnancy loss in the first and second trimester. Relevant congenital Mullerian tract anomalies include unicornuate, didelphys, bicornuate and septate uteri. Pregnancy loss has also been associated with acquired uterine abnormalities that distort the uterine cavity such as intrauterine adhesions and submucosal myomas. Initial evaluation of women with recurrent pregnancy loss should include a uterine assessment such as a pelvic ultrasound or sonohysterography. Uterine abnormalities such as uterine septum, intrauterine adhesions and submucosal myomas may be managed surgically with operative hysteroscopy.

Conclusion: Uterine abnormalities, both congenital and acquired, can be responsible for recurrent pregnancy loss.

Keywords: Infertility; Mullerian anomalies; Recurrent Pregnancy Loss; Uterine malformations; Uterus.

Publication types

  • Review

MeSH terms

  • Abortion, Habitual / diagnostic imaging
  • Abortion, Habitual / etiology
  • Abortion, Habitual / genetics
  • Abortion, Habitual / pathology*
  • Female
  • Humans
  • Hysteroscopy
  • Magnetic Resonance Imaging
  • Pregnancy
  • Ultrasonography
  • Urogenital Abnormalities / diagnostic imaging
  • Urogenital Abnormalities / pathology*
  • Uterine Diseases / diagnostic imaging
  • Uterine Diseases / genetics
  • Uterine Diseases / pathology*
  • Uterus / abnormalities*
  • Uterus / diagnostic imaging
  • Uterus / pathology*

Supplementary concepts

  • Uterine Anomalies