{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:31:48Z","timestamp":1793039508798,"version":"4.5.0"},"reference-count":161,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To summarize in a systematic review the current evidence regarding definitions, diagnosis, prevalence, etiology, clinical relevance and impact of surgical treatment for T\u2010shaped uterus not related to diethylstilbestrol (DES) exposure, and to highlight areas on which future research should focus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A search of PubMed, Scopus and EMBASE was performed on 9 April 2020 using the search terms \u2018t\u2010shaped OR t\u2010shape OR infantile OR (lateral indentation) OR (diethylstilbestrol OR DES) AND (uterus OR uterine OR uteri) AND (anomaly OR anomalies OR malformation OR malformations)\u2019. Additionally, the reference lists of the included studies were searched manually for other relevant publications. All studies presenting data on T\u2010shaped uterus not associated with DES exposure and including at least 10 women were considered eligible. Studies regarding DES\u2010related T\u2010shaped uterus were excluded because DES has not been used since 1971. There were no restrictions on language, date of publication or status of publication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2504 records identified by the electronic search, 20 studies were included in the systematic review. The majority of studies were of poor quality. In 11 of 16 studies reporting on the diagnosis of T\u2010shaped uterus, the diagnostic method used was three\u2010dimensional ultrasound. There is no consensus on the definition of T\u2010shaped uterus, but the most cited criteria (4\/16 studies) were of the European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy (ESHRE\/ESGE; 2013). The prevalence of T\u2010shaped uterus varied from 0.2% to 10% in the four included studies reporting such data. With respect to etiology (except for DES), T\u2010shaped uterus was considered a primary condition in three studies and secondary to adhesions in five and adenomyosis in one. T\u2010shaped uterus was related to worse reproductive outcome based on subfertility (nine studies), miscarriage (seven studies), preterm delivery (two studies), ectopic pregnancy (one study) and repeat implantation failure (seven studies). Of the 12 studies that reported on the effects of surgical treatment of T\u2010shaped uterus by hysteroscopic metroplasty, some mentioned an improvement in pregnancy rate (rates ranging from 49.6% to 88%; eight studies), live\u2010birth rate (rates ranging from 35.1% to 76%; seven studies) and term\u2010delivery rate (four studies) and a reduction in miscarriage (rates ranging from 7% to 49.6%; five studies) and ectopic pregnancy (one study). However, the evidence is of very low quality with serious\/critical risk of bias toward overestimating the intervention effect. Some authors reported no complications related to the procedure, while others mentioned persistence of the dysmorphism (rates ranging from  1.4% to 11%; three studies), bleeding (1.3%; one study), infection (2.6%; one study) and adhesions (11.1% and 16.8%; two studies).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prevalence, etiology and clinical relevance, with respect to reproductive outcome, of T\u2010shaped uterus remain unclear and there is no consensus on the definition and diagnostic method for this condition. Expectant management should be considered the most appropriate choice for everyday practice until randomized controlled trials show a benefit of intervention. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23108","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T11:40:15Z","timestamp":1601034015000},"page":"366-377","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Definition, prevalence, clinical relevance and treatment of T\u2010shaped uterus: systematic review"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3427-6059","authenticated-orcid":false,"given":"M. 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