Uterine Size, Shape Impact Reproductive Outcome.

HOT SPRINGS, VA. -- Women with large uteri or T-shaped cavities may be more prone to poor reproductive outcomes than those with smaller, more arcuate-shaped uteri, Dr. G. Ward Adcock III said at the annual meeting of the South Atlantic Association of Obstetricians and Gynecologists.

Uterine cavity shapes can vary dramatically, and there are almost no objective data describing "normal" uterine cavity shapes and sizes or what they indicate clinically.

"We do know that extreme sizes and shapes of uterine cavities, such as those of DES [diethylstilbestrol]-exposed patients, are very commonly associated with complicated pregnancies," commented Dr. Adcock, who is an ob.gyn. resident at Greenville (S.C.) Memorial Hospital.

In a study assessing the correlation between uterine size and shape, Dr. Adcock and his associates retrospectively analyzed 200 randomly selected hysterosalpingograms (HSGs).

They found that among women with a history of first-trimester pregnancy losses, 13 patients, or 31%, had an angle between their tubal ostia greater than 160 degrees, producing a markedly T-shaped uterus.

Among patients with a surgical diagnosis of endometriosis, "we found that 80% of patients had an angle between the tubal ostia of less than 90 degrees," giving the fundus of the uterus a Y-like or arcuate shape.

When the uterine areas were analyzed, 33% of the women who reported first-trimester pregnancy losses had uterine cavities that were larger than 11 [cm.sup.2]; these uterine cavities were significantly larger than those of women who did not experience pregnancy losses.