EP25.21: Unicornuate uterus: an observational retrospective study

To describe the reproductive outcomes of women with a unicornuate uterus in our unit. This was a single-centre retrospective cohort study. We included women aged at least 18 years, suspected/diagnosed with a unicornuate uterus on transvaginal ultrasound (US), between January 2014 and December 2023. Data were extracted from the patients' hard-copy and electronic files in the intranet network Hipocrate used by the Emergency University County Hospital of Craiova. Cases subjected to assisted reproductive techniques were excluded. During the study period, 34 women presented with a suspected unicornuate uterus, and 22 were confirmed using 3D-US, magnetic resonance, laparotomy or laparoscopy. There was a similar number of left and right hemiuteri (10 vs 12; p = 0.26). A rudimentary horn was confirmed in 7/22 (31.81%), 6 being non-functional horns. In 4 cases there was ipsilateral renal agenesis, in one we found an ectopic pelvic kidney. 4 cases had associated ovarian and extraovarian endometriosis. No women had US features of adenomyosis. 3 cases were referred for infertility, 4 were self-presented for pregnancy complications. One patient was diagnosed with a rudimentary-horn pregnancy following fetal demise at 18 weeks gestation. 13 patients presented with desired pregnancies, and 11 had a favourable outcome (median gestational age at birth 33.2 weeks). In 2 cases, ectopic tubal pregnancy occurred, and both patients remained infertile. Most probable, unicornuate uterus holds a higher risk for infertility, associated gynecological diseases, and pregnancy complications. Clear data, important for counselling patients, cannot be extracted from this study. Multicentre studies and international registries are needed. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.