摘要
目的探讨不孕患者中不同类型子宫畸形的患者是否存在不同的妊娠结局。方法回顾性分析2003年1月至2019年6月北京协和医院妇科病房收治的165例子宫畸形合并不孕症的病历资料,随访生育结局至2019年6月30日,剔除失访的病例,总计129例的妊娠结局纳入分析。比较不同类型子宫畸形组别的生育结局。结果41.9%患者除子宫畸形外,不存在其他不孕相关因素;合并子宫内膜异位症的比例(32.6%)明显高于一般非特指不孕人群。宫腹腔镜术处理后,纵隔单宫颈组妊娠率61.7%、流产率4.0%,单角单宫颈组妊娠率61.9%、流产率23.1%,纵隔双宫颈组妊娠率78.6%、流产率0%,双子宫双宫颈组妊娠率85.7%、流产率16.7%,双角单宫颈组妊娠率50%、流产率0%。根据宫腔形态有无可改善趋势整合分组为纵隔类和单角类,妊娠率分别为64.2%和67.9%,无显著性差异(P>0.05);流产率分别为3.28%和21.1%,有显著性差异(P<0.05)。结论非梗阻性子宫畸形可能不是导致不孕的重要原因,宫腔的容积可能主要跟早期流产风险相关,而非不孕的主要因素;期待有前瞻随机对照研究。
Objective:To investigate whether different types of uterine malformations in infertile patients have different pregnancy outcomes.Methods:The data of 165 patients with uterine malformation and infertility admitted by Department of Gynecology of Peking Union Medical College Hospital from January 2003 to June 2019 were retrospectively analyzed.Fertility outcomes were followed up to June 30,2019.A total of 129 patients were included in final retrospective analysis,excluding those who lost to follow-up.The fertility outcomes were compared among the groups.Results:41.9%patients had no other infertility related factors except uterine malformation,and the rate of concomitant endometriosis(32.6%)was significantly higher than that of non-specific infertile population(P<0.05).According to different types of uterine malformations,the pregnancy rate and the miscarriage rate in the group of uterus septum with single cervix were 61.7%and 4.0%respectively,and 61.9%and 23.1%in group of unicornuate uterus with single cervix,78.6%and 0%in the group of uterus septum with double cervix,85.7%and 16.7%in the group of uterus duplex with double cervix,50%and 0%in the group of bicornuate uterus with single cervix.According to whether the uterine cavity shape can be improved,it is grouped into septum group and unicornuate uterus group.The pregnancy rates were 64.2%and 67.9%respectively,without significant difference(P>0.05).There was a significant difference in miscarriage rate(3.28%vs.21.1%)(P<0.05).Conclusions:Non-obstructive uterine malformation may not be an important cause of infertility,and the volume of uterine cavity may be mainly related to the risk of early abortion,rather than the main factor of infertility.The prospective randomized controlled studies are still expected.
作者
李蕊
郁琦
孙爱军
田秦杰
陈蓉
邓姗
LI Rui;YU Qi;SUN Ai-jun;TIAN Qin-jie;CHEN Rong;DENG Shan(Department of Obstetrics&Gynecology,Peking Union Medical College Hospital,Peking Union Medical College/Chinese Academy of Medical Sciences,Beijing 100730;Maternity&Child Care Center of Qinhuangdao,Qinhuangdao 066000)
出处
《生殖医学杂志》
CAS
2020年第7期852-856,共5页
Journal of Reproductive Medicine
基金
国家自然科学基金(81571410)。
关键词
子宫畸形
不孕症
妊娠结局
Uterine malformation
Infertility
Pregnancy outcome
