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CONTACT: Patricia Enright202-452-9511 [email protected]
STUDY MEASURES PREVALENCE OF UTERINE ANOMALIES DETECTED DURING ULTRASOUND EXAMINATIONS
First attempt to establish the prevalence of these often-undetected defects of the uterus by pelvic ultrasound shows them to be more frequent than expected
Washington, DC (September 21, 2000) -- A new study published in the American Journal of Medical Genetics is the first to look at the prevalence of mullerian duct abnormalities (that is, anomalies of the uterus) in girls and women having ultrasound examinations for reasons unrelated to uterine abnormalities. In an attempt to determine the prevalence of abnormalities in the general population, this study found the rate of anomalies to be 3.87 per 1,000 women or approximately 1 in every 250 women. This is a significantly higher rate than suggested by existing data.
The study, titled "Prevalence of Mullerian Duct Anomalies Detected at Ultrasound," was conducted in three Washington, DC hospitals including Children's National Medical Center (CNMC). Study participants included 2,065 women and girls ranging from 8 to 94 years of age. The women screened at CNMC had an average age of 16.6 years and the women seen at the two adult hospitals had an average age of 40.7 years. Pregnant women were excluded from the study because advanced pregnancy makes it more difficult to identify a uterine anomaly. Ultrasound examinations of these women showed that eight had anomalies, including bicornuate uterus (having two branches instead of one), septate uterus (divided internally) and double uterus.
Since it is a non-invasive technology, ultrasound is often used as the first screen to evaluate a variety of complaints, such as fibroids, cysts and infections that may present as pelvic pain including fibroids, cysts and infections. The researchers took advantage of the large numbers of these examinations done routinely to ask a simple question: how many girls and women had anomalies of the uterus.
"The true prevalence of uterine abnormalities is not well established," said the study's designer and lead author Dr. Julianne Byrne, PhD, from the Center for Cancer and Blood Disorders and the Center for Health Services and Clinical Research at CNMC. "The intra-abdominal location of the uterus results in detection rates that are too low in some cases. On the other hand, observations can become inflated because the anomalies are often silent until malfunction (i.e. miscarriage or infertility) occurs. This study aimed to eliminate these considerable selection biases as far as possible."
Comparing the data from this study to prevalence figures derived from birth defects registries indicates that the latter may be significantly lower than the true rate. Data from the Atlanta Birth Defects Registry for the years 1968-1995 reported a rate of only 1 mullerian duct abnormality in 10,000 female births (in sharp contrast to the 1 in 250 suggested by this study).
The low rates of prevalence coming from birth defects registries may be due to the fact that they are registries of anomalies identified at birth only. Because ultrasound examinations are almost never performed on newborns, internal defects such as uterine anomalies may go unnoticed. As problems come up when children get older, more birth defects will be detected later in life. The true rate of all birth defects is probably quite high, possibly around 10%, instead of the generally accepted 2-3% at birth.
"This new data suggests that uterine anomalies occur much more frequently than previously estimated," said Dr. Byrne. "In light of the fact that women with this condition are predisposed to high-risk pregnancy or infertility it is important to recognize these abnormalities whenever possible. We also found that women who suffer from Wilm's tumor, a childhood cancer, are 25 times more likely to have uterine anomalies as well. Our data suggest that all women who have had Wilm's tumor should be screened with ultrasound and referred to a high-risk pregnancy clinic if they have mullerian duct abnormalities."
Children's National Medical Center, located in Washington, D.C., is a leader in the development of innovative new treatments for childhood illness and injury. Among the top 15 pediatric hospitals in America, Children's National Medical Center (CNMC) has been serving the nation's children for over 125 years. CNMC's newly developed Centers of Excellence programs include: Neurosciences and Behavioral Medicine; Cancer and Blood Disorders; Heart and Kidney Disease; and Community Pediatric Health. The Centers of Excellence program and an internationally recognized team of pediatric health care professionals allow Children's National Medical Center to care for thousands of families throughout the region, the nation, and the world. In addition, Children's serves as the regional referral center for pediatric emergency, trauma care, cancer, burn, neonatology, and critical care.
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For additional information on the Centers of Excellence program at Children's National Medical Center, please contact Patricia Enright at 202-452-9511 or via e-mail at: [email protected].
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