Reproductive impairment of women with unicornuate uterus.

The reproductive history of 18 women with a diagnosis of unicornuate uterus is reported. The study was conducted with retrospective analysis, and 7 patients with primary infertility were followed up for 1 to 6 years. Four patients had a cavitary noncommunicating horn, 12 a noncavitary rudimentary horn, and 2 no rudimentary horn. The cause of diagnosis was: primary infertility in 7 cases (39%), recurrent abortion in 6 (33%), obstetric complications in 5 (28%). Out of 7 patients that presented with primary infertility in 5 cases an associated reason was present. Twelve women had a total of 38 pregnancies, 21 (55%) ended in abortion, 3 in premature labour, 14 in term births, with a live birth rate of 39%. Of the 17 births 9 (53%) were in breech and 1 (1.6%), in transverse presentations and 11 (65%) were cesarean sections. Cervical cerclage, based on clinical or radiological indications, has been performed in 4 out 6 cases with recurrent abortion with improvement of reproductive performance in 3. Fetal survival rate passed from 0 to 83%. Reproductive impairment seems to depend equally on the difficulty in conceiving and on the reduced ability to carry a pregnancy to term.