(947) Placental complications in patients with Mullerian anomalies

Mullerian anomalies are associated with adverse pregnancy outcomes and specifically preterm deliveries. However, scarce data exists regarding placental complications. This study aimed to determine whether women with Mullerian anomalies have a higher rate of placental complications.

Study Design: A retrospective population-based cohort study was conducted comparing placental complications in women with and without Mullerian anomalies. We evaluated all deliveries that occurred between the years 1991 and 2021 at a tertiary medical center. Multiple gestations and chromosomal abnormalities were excluded. Multiple logistic regression models were used to control for confounding variables.

Results:

During the study period, 356,356 deliveries met inclusion criteria, 0.4% (n=1283) of whom were diagnosed with Mullerian anomalies. Placental complications, including placenta previa, placenta accreta, placental abruption, residua and also the need for blood transfusion were significantly more prevalent in women with Mullerian anomalies (Table). Using multiple logistic regression models, Mullerian anomalies were found as an independent risk factor for placenta previa (adjusted OR 1.82; 95% confidence interval(CI) , 1.12-2.97; p< 0.001), placenta accreta (adjusted OR 1.66 ; 95% CI, 1.01-2.74; p=0.004), abruption (adjusted OR 2.66 ; 95% CI, 1.84- 3.86; p< 0.001), residua (adjusted OR 1.43; 95%, (1.01- 2.03); p=0.002) and receiving blood transfusion (adjusted OR 1.47; 95% CI, 1.05-2.06; p< 0.001; Table), while controlling for maternal age and gestational age.

Conclusion: Mullerian anomalies are associated with placental complications. Women with Mullerian anomalies should receive meticulous care during pregnancy and delivery to address potential placental complications.