{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:08:10Z","timestamp":1789600090576,"version":"build-2803163510"},"reference-count":48,"publisher":"Georg Thieme Verlag KG","issue":"09","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Congenital uterine malformations are often associated with uncertainty regarding pregnancy outcomes and reproductive counseling. Data on obstetric outcomes stratified by detailed anatomical classification remain limited.<\/jats:p>\n                  <jats:p>In this retrospective observational case series, pregnancy and delivery outcomes were analyzed in women with congenital uterine malformations classified according to the VCUAM system. The cohort included 95 deliveries in women with septate (U1, n\u00a0=\u00a049), bicornuate (U2, n\u00a0=\u00a040), or unicornuate (U4a, n\u00a0=\u00a06) uterus managed at a tertiary perinatal referral center. Pregnancy complications, mode of delivery, peripartum complications, and neonatal outcomes were assessed descriptively.<\/jats:p>\n                  <jats:p>Overall, 68.8% of pregnancies (64\/93; 95% CI 58.7\u201377.4) occurred without documented complications. Cervical insufficiency was observed in 12.9% (12\/93; 95% CI 7.6\u201321.2) and preterm labor in 7.5% (7\/93; 95% CI 3.7\u201314.7). Severe obstetric complications were rare. Cesarean delivery was common. However, vaginal delivery was achieved in all uterine subtypes. Neonatal condition at birth was generally reassuring across groups.<\/jats:p>\n                  <jats:p>In this cohort of deliveries among women with congenital uterine malformations reaching viable pregnancy, most pregnancies progressed without documented major complications and neonatal outcomes were generally favorable. These findings support individualized reproductive counseling and structured obstetric surveillance while avoiding assumptions based solely on uterine anatomy.<\/jats:p>","DOI":"10.1055\/a-2919-2404","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T23:23:05Z","timestamp":1786404185000},"page":"837-846","source":"Crossref","is-referenced-by-count":0,"title":["Congenital Uterine Malformations and Pregnancy Outcomes: A Retrospective Observational Study to Inform Reproductive Counseling"],"prefix":"10.1055","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9162-8287","authenticated-orcid":false,"given":"Julia","family":"Lastinger","sequence":"additional","affiliation":[{"name":"Kepler University Hospital, Johannes Kepler University, Austria","place":["Linz"],"department":["Department of Gynecology, Obstetrics and Gynecological Endocrinology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gruber","sequence":"additional","affiliation":[{"name":"Kepler University Hospital, Johannes Kepler University, Austria","place":["Linz"],"department":["Department of Gynecology, Obstetrics and Gynecological Endocrinology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Eichinger","sequence":"additional","affiliation":[{"name":"Kepler University Hospital, Johannes Kepler University, Austria","place":["Linz"],"department":["Department of Gynecology, Obstetrics and Gynecological Endocrinology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0353-0029","authenticated-orcid":false,"given":"Stephanie","family":"Kiblboeck","sequence":"additional","affiliation":[{"name":"Kepler University Hospital, Johannes Kepler University, Austria","place":["Linz"],"department":["Department of Gynecology, Obstetrics and Gynecological Endocrinology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3487-4561","authenticated-orcid":false,"given":"Simon-Hermann","family":"Enzelsberger","sequence":"additional","affiliation":[{"name":"Kepler University Hospital, Johannes Kepler University, Austria","place":["Linz"],"department":["Department of Gynecology, Obstetrics and Gynecological Endocrinology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Oppelt","sequence":"additional","affiliation":[{"name":"Kepler University Hospital, Johannes Kepler University, Austria","place":["Linz"],"department":["Department of Gynecology, Obstetrics and Gynecological Endocrinology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia Anna","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Kepler University Hospital, Johannes Kepler University, Austria","place":["Linz"],"department":["Department of Gynecology, Obstetrics and Gynecological Endocrinology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1259\/bjr\/99354802","article-title":"Mullerian duct anomalies: from diagnosis to intervention","volume":"82","author":"TM Chandler","year":"2009","journal-title":"Br J Radiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1093\/humupd\/dmr028","article-title":"The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review","volume":"17","author":"YY Chan","year":"2011","journal-title":"Hum Reprod Update"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1093\/humupd\/dmn018","article-title":"Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal","volume":"14","author":"SH Saravelos","year":"2008","journal-title":"Hum Reprod Update"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/j.fertnstert.2014.04.043","article-title":"Mullerian duct anomalies diagnosed by saline contrast sonohysterography: prevalence in a general population","volume":"102","author":"E Dreisler","year":"2014","journal-title":"Fertil Steril"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1016\/j.fertnstert.2021.09.025","article-title":"ASRM m\u00fcllerian anomalies classification 2021","volume":"116","author":"SM Pfeifer","year":"2021","journal-title":"Fertil Steril"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1016\/S0015-0282(16)59942-7","article-title":"The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, M\u00fcllerian anomalies and intrauterine adhesions","volume":"49","author":"[Anonym]","year":"1988","journal-title":"Fertil Steril"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/S0015-0282(16)44114-2","article-title":"M\u00fcllerian Anomalies: A Proposed Classification (An Analysis of 144 Cases)","volume":"32","author":"VC Buttram","year":"1979","journal-title":"Fertil Steril"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1093\/humrep\/det098","article-title":"The ESHRE\/ESGE consensus on the classification of female genital tract congenital anomalies","volume":"28","author":"GF Grimbizis","year":"2013","journal-title":"Hum Reprod"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1016\/j.fertnstert.2005.05.036","article-title":"The VCUAM (Vagina Cervix Uterus Adnex\u2013associated Malformation) Classification: a new classification for genital malformations","volume":"84","author":"P Oppelt","year":"2005","journal-title":"Fertil Steril"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.fertnstert.2006.07.1501","article-title":"Female genital malformations and their associated abnormalities","volume":"87","author":"P Oppelt","year":"2007","journal-title":"Fertil Steril"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1055\/a-2043-9982","article-title":"Can Classifications Adequately Represent Genital Malformations?: EVA Study (E SHRE\/ESGE | V CUAM | A FS) \u2013 A Prospective Multicenter Study to Evaluate the Current Female Genital Malformation Classifications","volume":"83","author":"S Kiblboeck","year":"2023","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/S0301-2115(99)00259-6","article-title":"Clinical implications of the didelphic uterus: long-term follow-up of 49 cases","volume":"91","author":"PK Heinonen","year":"2000","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1007\/s00404-022-06557-6","article-title":"Perinatal outcomes of women with Mullerian anomalies","volume":"307","author":"S Wang","year":"2023","journal-title":"Arch Gynecol Obstet"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.rbmo.2014.09.006","article-title":"Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies","volume":"29","author":"CA Venetis","year":"2014","journal-title":"Reprod Biomed Online"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"4797","DOI":"10.3390\/jcm10214797","article-title":"Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis","volume":"10","author":"MA Kim","year":"2021","journal-title":"J Clin Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"10494","DOI":"10.1080\/14767058.2022.2130240","article-title":"What type of uterine anomalies had an additional effect on pregnancy outcomes, compared to other uterine anomalies? An evaluation of a large population database","volume":"35","author":"E Kadour Peero","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1002\/uog.10056","article-title":"Reproductive outcomes in women with congenital uterine anomalies: a systematic review","volume":"38","author":"YY Chan","year":"2011","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1080\/14767058.2017.1370703","article-title":"The association between M\u00fcllerian anomalies and perinatal outcome","volume":"32","author":"A Cahen-Peretz","year":"2019","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/AOG.0000000000004627","article-title":"Obstetric Complications in Women With Congenital Uterine Anomalies According to the 2013 European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy Classification: A Systematic Review and Meta-analysis","volume":"139","author":"M Panagiotopoulos","year":"2022","journal-title":"Obstet Gynecol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2408","DOI":"10.1080\/14767058.2018.1432588","article-title":"The association between Mullerian anomalies and IUGR: a meta-analysis","volume":"32","author":"M Karami","year":"2019","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.3390\/healthcare13091076","article-title":"The Impact of Prenatal Care on the Prevention of Neonatal Outcomes: A Systematic Review and Meta-Analysis of Global Health Interventions","volume":"13","author":"MN Albarqi","year":"2025","journal-title":"Healthcare"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1007\/s12519-025-00927-1","article-title":"Neonatal care in the twenty-first century: innovations and challenges","volume":"21","author":"A \u00c7eri","year":"2025","journal-title":"World J Pediatr"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1055\/a-2593-0275","article-title":"Perinatal Neuroprotection in Preterm Birth","volume":"85","author":"R Berger","year":"2025","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.3390\/medicina61061077","article-title":"Neonates at Risk: Understanding the Impact of High-Risk Pregnancies on Neonatal Health","volume":"61","author":"R Sokou","year":"2025","journal-title":"Medicina (Mex)"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoad002","article-title":"ESHRE guideline: recurrent pregnancy loss: an update in 2022\u2020","volume":"2023","author":"R Bender Atik","year":"2023","journal-title":"Hum Reprod Open"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1002\/uog.20291","article-title":"Septate uterus according to ESHRE\/ESGE, ASRM and CUME definitions: association with infertility and miscarriage, cost and warnings for women and healthcare systems","volume":"54","author":"A Ludwin","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1983","DOI":"10.1016\/j.fertnstert.2008.12.097","article-title":"Midline uterine defect size is correlated with miscarriage of euploid embryos in recurrent cases","volume":"93","author":"M Sugiura-Ogasawara","year":"2010","journal-title":"Fertil Steril"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"949","DOI":"10.3109\/14767058.2013.847082","article-title":"Type of congenital uterine anomaly and adverse pregnancy outcomes","volume":"27","author":"NS Fox","year":"2014","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"10494","DOI":"10.1080\/14767058.2022.2130240","article-title":"What type of uterine anomalies had an additional effect on pregnancy outcomes, compared to other uterine anomalies? An evaluation of a large population database","volume":"35","author":"E Kadour Peero","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2024.101396","article-title":"Obstetric outcomes of women with congenital uterine anomalies in the United States","volume":"6","author":"RS Mandelbaum","year":"2024","journal-title":"Am J Obstet Gynecol MFM"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1007\/s00404-018-4663-2","article-title":"Independent association between uterine malformations and cervical insufficiency: a retrospective population-based cohort study","volume":"297","author":"SA Mastrolia","year":"2018","journal-title":"Arch Gynecol Obstet"},{"key":"ref34","first-page":"277","article-title":"The Role of Cervical Cerclage in Pregnancy Outcome in Women with Uterine Anomaly","volume":"12","author":"F Yassaee","year":"2011","journal-title":"J Reprod Infertil"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1111\/aogs.13923","article-title":"Cervical length surveillance for predicting spontaneous preterm birth in women with uterine anomalies: A cohort study","volume":"99","author":"KM Hughes","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"157","DOI":"10.3109\/00016348209156548","article-title":"Reproductive Performance of Women with Uterine Anomalies","volume":"61","author":"PK Heinonen","year":"1982","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1177\/2050313X251377288","article-title":"Usage of cervical cerclage in pregnancy with Mullerian anomalies and cervical insufficiency: A case report","volume":"13","author":"W Maulida","year":"2025","journal-title":"Sage Open Med Case Rep"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1002\/ijgo.70140","article-title":"Uterus didelphys bicollis bicolpos\u2014a case report","volume":"170","author":"F Nyagaka","year":"2025","journal-title":"Int J Gynecol Obstet"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e86","DOI":"10.1111\/1471-0528.18054","article-title":"Reproductive Implications and Management of Congenital Uterine Anomalies: Scientific Impact Paper No. 62","volume":"132","author":"MA Akhtar","year":"2025","journal-title":"BJOG"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"527","DOI":"10.2147\/IJWH.S218933","article-title":"Retained placenta after vaginal delivery: risk factors and management","volume":"11","author":"NC Perlman","year":"2019","journal-title":"Int J Womens Health"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2024.101396","article-title":"Obstetric outcomes of women with congenital uterine anomalies in the United States","volume":"6","author":"RS Mandelbaum","year":"2024","journal-title":"Am J Obstet Gynecol MFM"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"7406","DOI":"10.1080\/14767058.2021.1949446","article-title":"The association between congenital uterine anomalies and perinatal outcomes \u2013 does type of defect matters?","volume":"35","author":"A Naeh","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/865821","article-title":"Didelphys uterus: a case report and review of the literature","volume":"2015","author":"S Rezai","year":"2015","journal-title":"Case Rep Obstet Gynecol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"198","DOI":"10.3390\/medicina56040198","article-title":"Pregnancy and childbirth in uterus didelphys: a report of three cases","volume":"56","author":"S Slavchev","year":"2020","journal-title":"Medicina (Mex)"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"10571","DOI":"10.3390\/ijerph191710571","article-title":"The Impact of Uterus Didelphys on Fertility and Pregnancy","volume":"19","author":"A \u0106wiertnia","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.889696","article-title":"Pregnancy and adverse obstetric outcomes after hysteroscopic resection: a systematic review and meta-analysis","volume":"9","author":"X Wu","year":"2022","journal-title":"Front Surg"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.fertnstert.2024.02.033","article-title":"Evidence-based diagnosis and treatment for uterine septum: a guideline","volume":"122","author":"Practice Committee of the American Society for Reproductive Medicine","year":"2024","journal-title":"Fertil Steril"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1093\/humrep\/deab037","article-title":"Septum resection versus expectant management in women with a septate uterus: an international multicentre open-label randomized controlled trial","volume":"36","author":"JFW Rikken","year":"2021","journal-title":"Hum Reprod"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1474","DOI":"10.1007\/s10995-021-03183-7","article-title":"Cesarean Section Rate and Perinatal Outcome Analyses According to Robson\u2019s 10-Group Classification System","volume":"25","author":"C Eftekharian","year":"2021","journal-title":"Matern Child Health J"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1055\/a-1471-4781","article-title":"Diagnosis and Therapy of Female Genital Malformations (Part 1). Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015\/052, May 2019)","volume":"81","author":"P Oppelt","year":"2021","journal-title":"Geburtshilfe Frauenheilkd"}],"container-title":["Geburtshilfe und Frauenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2919-2404.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:32:41Z","timestamp":1789597961000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2919-2404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":48,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2026,9,16]]},"published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2919-2404","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0016-5751","1438-8804"],"issn-type":[{"value":"0016-5751","type":"print"},{"value":"1438-8804","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]}}}