Various Müllerian-duct anomalies in Women at Rural Tertiary Care Center of Northern India: An Observational Study

Abstract

Aims: Present study was conducted to know presentations and nature of Müllerian-duct anomalies in rural women. Background: Müllerian anomalies are congenital defects of female reproductive tract resulting from faulty development and fusion of Müllerian ducts. Objectives: To identify common Müllerian anomalies, their presentation, radiological appearances, complications, associated renal anomalies in rural women of Northern India. Methods: Present observational study was conducted on 181 female patients with suspected Müllerian anomalies presenting to the outpatient department of Obstetrics and Gynecology with various complaints. Data included age, religion, menarche, previous pregnancy if any, duration of infertility, presenting complaints, type of Müllerian anomaly, incidental or symptomatic, diagnostic method, associated anomalies. Statistical analysis was done using SPSS 22.0 version software. Results: Of 181 patients, 16.5% were adolescents, 83.5% adult women with an overall mean (SD) age of 25.02 (5.96) years. Of these, 170 had true Müllerian-duct anomalies and 11 had defects other than Müllerian anomalies, hence excluded. Total 158(92.9%) patients were symptomatic and 12(7.1%) asymptomatic at presentation. The majority (75.9%) were diagnosed incidentally during their visit to the department for various complaints of which infertility (32.4%) was most common. Septate uterus (29.4%) was most common anomaly diagnosed followed by Müllerian agenesis/hypoplasia (22.9%). Around 11.2% cases had associated renal and collecting system anomalies with unilateral renal agenesis (47.4%) being most common. Conclusion: Hence, Müllerian-duct anomalies have diverse presentations and most of them are diagnosed incidentally. Other: The exact prevalence of Müllerian-duct anomalies may be high, especially in rural India due to lack of knowledge and societal pressures.