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Female genital tract congenital malformations and the applicability of the ESHRE/ESGE classification: a systematic retrospective analysis of 920 patients

  • General Gynecology
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Abstract

Purpose

Several classification systems for female genital tract anomalies exist but are of limited use in clinical practice. We, therefore, assessed the applicability and ease of use of the new ESHRE/ESGE classification, using only patient records.

Methods

This retrospective, single-center, proof-of-principle study systematically analyzed the surgical reports and other hospital records of 920 inpatients and outpatients treated for confirmed female genital tract congenital malformations at a major German university hospital during 2003–2013. Using only this information, a non-expert (medical student) assigned patients to an ESHRE/ESGE class, rating ease of classification based on the time and the number of additional medical records required. Results were verified by an expert gynecologist, who also classified any malformations previously left unclassified. Data analysis used descriptive statistics.

Results

The non-expert successfully classified 859/920 patients (93.4%), rating classification as “easy” for 836/859 (90.9%) and “moderately difficult” for 23/859 (2.5%) patients. The expert gynecologist successfully classified 60 (60/920, 6.5%) of the remaining 61 patients rated as “difficult” by the non-expert, but was unable to accurately subclassify 1 patient (1/920, 0.1%) because the operative report lacked the relevant details. 251/920 (27.3%) patients had associated non-Müllerian anomalies, most frequently renal (20.9%) and skeletal (9.1%) malformations.

Conclusions

The ESHRE/ESGE classification provides a generally applicable, comprehensive, and adequately specific classification of female genital tract congenital malformations. It offers an efficient basis for communication between non-experts and experts in the field and is, therefore, useful in clinical management and treatment planning.

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Abbreviations

AFS:

American Fertility Society, now the American Society for Reproductive Medicine

ASRM:

American Society for Reproductive Medicine

ESGE:

European Society for Gynaecological Endoscopy

ESHRE:

European Society of Human Reproduction and Embryology

ICD-10:

International classification of diseases, 10th revision

MRKHS:

Mayer–Rokitansky–Küster–Hauser syndrome

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Funding

No funding was received.

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Authors and Affiliations

  1. Research Institute for Women’s Health, Department of Women’s Health and Department of Obstetrics and Gynecology, University of Tübingen, Calwerstr. 7, 72076, Tübingen, Germany

    Dorit Schöller, Marieke Hölting, Diana Stefanescu, Helen Burow, Birgitt Schönfisch, Katharina Rall, Florin-Andrei Taran & Sara Y. Brucker

  2. 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Tsimiski 51 Street, 54623, Thessaloníki, Greece

    Grigoris F. Grimbizis

  3. Department of Public Health, School of Medicine, University of Naples “Federico II”, Via Pansini 5, 80131, Naples, Italy

    Attilio Di Spiezio Sardo

Authors
  1. Dorit Schöller
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  2. Marieke Hölting
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  3. Diana Stefanescu
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  4. Helen Burow
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  5. Birgitt Schönfisch
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  6. Katharina Rall
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  7. Florin-Andrei Taran
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  8. Grigoris F. Grimbizis
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  9. Attilio Di Spiezio Sardo
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  10. Sara Y. Brucker
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Contributions

DS participated in data collection and interpretation, wrote and reviewed the draft manuscript, and prepared the final version. MH participated in data collection and interpretation and contributed to drafting and reviewing the manuscript. DSt, HB, and FAT participated in data collection and interpretation and contributed to drafting and reviewing the manuscript. BS oversaw data analysis, participated in data interpretation, and contributed to drafting and reviewing the manuscript. KR participated in designing the study, data collection, analysis, and interpretation, and contributed to drafting and reviewing the manuscript and preparing the final version. GG and ADSS participated in data interpretation and contributed to drafting and reviewing the manuscript. SYB conceived and designed the study, participated in data collection and interpretation, and contributed to drafting and reviewing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sara Y. Brucker.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study received prior approval (No. 205/2014BO1) from the Ethics Committee of the Medical Faculty of the University of Tübingen. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The study retrospectively analyzed anonymized data from existing hospital records. For this type of study, formal consent is not required. Nonetheless, all participants gave their written informed consent to use their data in scientific studies and research publications.

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Schöller, D., Hölting, M., Stefanescu, D. et al. Female genital tract congenital malformations and the applicability of the ESHRE/ESGE classification: a systematic retrospective analysis of 920 patients. Arch Gynecol Obstet 297, 1473–1481 (2018). https://doi.org/10.1007/s00404-018-4749-x

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