Background: Congenital uterine anomalies represent developmental disorders of the Mllerian ducts with potential impact on reproductive outcomes.This study investigates the association between specific uterine anomalies and fetal malpresentation, an area where comprehensive clinical characterization remains incomplete.Materials and methods: This retrospective case series examined 12 pregnant women with confirmed uterine anomalies who delivered at the Department of Obstetrics and Gynecology in MGM Kalamboli, Navi Mumbai.Uterine anomalies were classified according to ESHRE/ESGE criteria.Data collected included maternal demographics, anomaly type, fetal presentation, delivery mode, and neonatal outcomes.Descriptive statistical analysis was performed to evaluate associations between specific anomalies and malpresentation patterns.Results: Among the 12 cases, a bicornuate uterus was the most frequent (41.7%), followed by septate (33.3%), didelphys (16.7%), and arcuate uterus (8.3%).Malpresentation occurred in 83.3% of cases, with 58.3% breech and 25% transverse lie.A septate uterus was associated with 100% malpresentation (75% breech, 25% transverse), while a bicornuate uterus showed 80% malpresentation (60% breech, 20% transverse).The cesarean section rate was 91.7%, with malpresentation being the primary indication in 90.9% of these cases.Despite these challenges, neonatal outcomes were favorable, with 100% of neonates having APGAR scores 7 at 5 minutes and no congenital anomalies. Conclusion:This study demonstrates a strong association between uterine anomalies and fetal malpresentation, with septate and bicornuate uteri showing particularly high rates of non-cephalic presentations.The consequent high cesarean section rate highlights the significant impact of these anomalies on obstetric management.Early detection of uterine anomalies and appropriate antenatal surveillance are essential for optimizing outcomes in this high-risk population.
Khutale et al. (Fri,) studied this question.