Abstract
Two groups of age-, parity-, and pregnancy-matched women, viz. 78 with oligomenorrhea (A) and 78 with normal menstrual intervals (B), plus all women with regular menstruation but in whom severe Müllerian malformations had been diagnosed during the same period (C) were followed in a prospective study to detect complications, sonographic changes, and the serum oxytocinase concentration during pregnancy and labor. Among the matched groups A and B, ultrasonic scanning revealed uterine changes in 45% and 9%. respectively (p < 0.0005) during the 2nd trimester. Among the oligomenorrheic women who had HSG, fairly mild Müllerian malformations were fo—in 40%. The sonographic method in these mild and moderate anomalies had its Iimmations, and the findings were interpreted in several cases as fibroma or contractions. Complications occurred in 51% of the group A women who carried their pregnancies to term versus 20% in group B (p < 0.0005). Among the primiparae the complication rates were 47% and 22%, respectively (p < 0.025). Bleeding in early pregnancy (25%), an unstable fetal lie (28%), malpresentations (14%), and premature contractions or delivery (11%) were more common in group A (p < 0.05—0.01). On stratification of the oligomenorrheic group without or with Müllerian anomalies (A2 and A) the overall complication rates were 55% and 73%, respectively, and 86% in group C. Mutually, these differences are not statistically different, but all differ significantly from the control group (B) (p < 0.005). As regards specific complications, group A1, unlike the other groups, differed statistically from the control group only in malpresentation. No differences in the serum oxytocinase concentration between the three main groups were demonstrable. It is concluded that obstetric complications in women with the syndrome ‘minor Müllerian anomalies and oligomenorrhea’ are presumably not due solely to the congenital anatomic effect, but rather to its combination with pathophysiological muscular dysfunction.