This project, led by CAIRHE investigator Miranda Margetts, Ph.D., examined health care for young girls and women with Congenital Uterine Anomalies (CUAs), also known as Müllerian Anomalies, in Montana. CUAs are complex developmental gynecological disorders found in 7% of the female population, causing pelvic pain, prolonged or abnormal bleeding at the time of menarche, recurrent pregnancy loss, preterm delivery, and sub- and infertility. Severe CUA variations are usually diagnosed in adolescence because of the absence of menstruation or painful menstruation. Milder variations of CUAs are often diagnosed in the later reproductive years when women face fertility challenges or pregnancy complications. Associated renal, skeletal, cardiovascular, and auditory malformations require women with CUAs to undergo specialized gynecological and overall health care throughout their lives. This project transitioned into a CAIRHE Research Project in 2023-24.

Our Research Goals were:

  • To explore specific barriers and supports related to diagnoses and treatment for rural women with complex gynecological conditions to assist these patients in achieving the highest possible level of health. The opportunity to discover the strengths and resources leveraged by rural health care teams to support their patients with CUAs in navigating this journey can promote effective care models that may prove valuable for many rural patients with this condition. Exploratory data analysis of electronic health record systems will also address a key knowledge gap of comorbidities associated with CUAs in rural patients.
  • In partnership with physicians and scientists at the Billings Clinic in Montana, and the Primary Children’s Hospital/University of Utah in Salt Lake City, we will determine the extent of travel required by Montanan patients both within the state and interstate (in this phase, to Utah) to receive care.
  • To develop a survey to be administered to patients (Year 2) with a CUA diagnosis to provide greater insight into patient experience of the condition, and ultimately explore potential causative environmental and genetic factors.

Our Research Collaborators:

A Clinical Advisory Team has been established to identify supports and barriers related to CUA diagnoses and treatment, understand best practice workflow protocols relevant to treatment for the condition, guide the development of the research study, and aid in establishing a Patient Advisory Board for Phase 2 of the project.

Margetts MacCarter Hedges Carter McCracken

Miranda Margetts

Bethany MacCarter

David Hedges

Benjamin Carter

Clayton McCracken
Milroy Shomento Hayes Margita Pelosi

Colleen Milroy

Stacy Shomento

Katherine Hayes

Alla Vash-Margita

Emanuele Pelosi

Members of the Project Team:

  • Miranda Margetts, Ph.D. (Project Leader), Assistant Research Professor, CAIRHE, MSU
  • Bethany MacCarter, Project Manager, CAIRHE, MSU
  • David Hedges, Ph.D., Lead Data Scientist, Billings Clinic
  • Benjamin Carter, Ph.D., Biostatistician, Billings Clinic
  • Clayton McCracken, M.D., OB/GYN, Billings Clinic
  • Colleen Milroy, M.D., OB/GYN and Reproductive Endocrinologist, Billings Clinic
  • Stacy Shomento, M.D., OB/GYN and Reproductive Endocrinologist, Billings Clinic
  • Katherine Hayes, M.D., Chief, Division of Pediatric and Adolescent Gynecology, Primary Children’s Hospital/University of Utah
  • Alla Vash-Margita, M.D., Chief, Division of Pediatric and Adolescent Gynecology, Yale University School of Medicine
  • Emanuele Pelosi, Ph.D., Fertility Theme Research Leader, University of Queensland, Australia

You can learn more about Congenital Uterine Anomalies and the research team in this Yale Medicine article: https://www.yalemedicine.org/news/mullerian-anomalies. 

For futher information about our project, please contact Project Leader Dr. Miranda Margetts at [email protected].