Frequency of Uterine Malformation among Women in a Restricted Gene Pool Community : A retrospective cross-sectional study in La Crete, Canada

Abstract

Objective: This random retrospective cross-sectional study was done to determine the incidence of uterine malformation in 4 groups of women desiring to conceive during their reproductive years, all of them living in La Crete, a community in Northern Alberta, Canada, with endogamous marriage practices in a 500 year old restricted gene pool. Methods: During 2003-2006, eight hundred women, suspected of having uterine malformation, were scanned using 2-D abdominal and transvaginal sonography (TVS). A sub-group of 156 patients was identified with suspected uterine malformations and referred for further diagnostic investigation, including MRI, 3-D sonography, hysterosalpingography, hysteroscopy and laparoscopy. This group included 30 women without previous pregnancies (Group 1), 31 women with previous pregnancies and live births (fertile) (Group 2), 40 women with live births and more than 2 miscarriages (Group 3) and 55 women with recurrent miscarriages (infertile) (Group 4). Results: The overall frequency of uterine malformations was recorded at 19.5% in La Crete women. Ninety five women with recurrent or some miscarriages had more uterine malformation than the other groups. The incidence in Groups 3 and 4 (infertile) was 60.8% and 39.2% in the fertile Groups 1 and 2. The p <0.01 was significant at 95% confidence interval. Conclusion: This study has provided new insights into the increasing number of uterine malformations in the population of La Crete. It was 19.5%, 5.5 times higher than that of the general population of (0.1% to 3.5%). This might indicate an increase in uterine malformations among women in a restricted gene pool community. A combination of TVS, hysterosalpingography, 3-D sonography and MRI are necessary for the precise classification of uterine malformations.Uterine malformations are not rare, but may be increasingly related to consanguinity. The finding of uterine malformation is more frequent in patients with recurrent miscarriages, especially women with septated, unicornuate, or didelphys uteri.