THE IMPACT OF CONGENITAL UTERINE ANOMALIES ON PREGNANCY OUTCOMES

Objective: To study the course of pregnancy, childbirth, and perinatal outcomes in patients with various congenital uterine anomalies (CUAs) Methods: A retrospective case-control study was conducted involving the maternity records of 232 patients, along with monitoring and examination of 97 gravidas with CUAs admitted to City Maternity Hospital No. 1 in Dushanbe, Republic of Tajikistan for delivery. Gravidas with CUAs formed the main group. Additionally, a control group was established, consisting of 38 healthy gravidas and puerperants. The study focused on examining the characteristics of pregnancy, labor, perinatal outcomes, and the morphological features of the placenta in gravidas with CUAs. Results: The study found a high incidence of threatened miscarriage and premature birth among gravidas with CUAs. Both conditions resulted in spontaneous abortions in 7.2% of cases, non-viable pregnancies in 3.1%, and premature births in 11.8%. Additionally, there were elevated rates of chronic pyelonephritis recurrence alongside various other renal conditions throughout all three trimesters of pregnancy. From the second trimester onward, signs of intrauterine hypoxia and fetal growth retardation were observed. Ultrasound assessments confirmed these findings: intrauterine growth retardation was diagnosed in 12 patients (14.1%), and placental insufficiency was identified in 25 cases (29.4%). Unfortunately, there were four cases (4.7%) of antenatal mortality reported as well. The most common delivery complications were abnormal labor (35.3%), hypertensive disorders (23.5%), placental detachment (4.8%), two cases (2.3%) of threatened uterine rupture, and one case (1.2%) of uterine rupture. Breech presentation (27.1%) and fetal malposition (17.3%), along with complications during labor such as abnormal labor (35.3%), threatened uterine rupture, and uterine rupture, accounted for CS in 82.3% of cases. Among those with a bicornuate uterus, 78.5% of CS were performed as emergencies. Morphological studies showed pathological changes in all components of the placenta in women with CUAs. Conclusion: The research findings revealed that CUAs have adverse effects throughout all stages of pregnancy and childbirth. These findings highlight the necessity for early diagnosis and thorough monitoring of gravidas, parturients, and puerperants with CUAs. It is essential to adopt a specialized approach to managing their pregnancies and preventing obstetric risks to improve outcomes and reduce both maternal and perinatal morbidity and mortality. Keywords: Uterine anomalies, spontaneous miscarriage, intrauterine growth retardation, cesarean section (CS), placental insufficiencyy.