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Reproductive Outcome in Women with Congenital Uterine Anomalies

机译:先天性子宫异常妇女的生殖结果

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Background: Mullerian duct malformations delineate a group of congenital anomalies that result from arres-ted development, or incomplete fusion of the mesone-phric ducts. In many patients, uterine anomalies have been related with infertility, recurrent pregnancy loss, prematurity and other obstetric complications which increase perinatal morbidity and mortality rates, where as in others these malformations are asymptomatic and have normal reproductive performance. Purpose: To determine the reproductive outcome in women with congenital uterine anomalies. Design: Descriptive cross sectional survey. Main Outcome Measures: Miscarriages, Preterm delivery, Ecotpic pregnancy, Term delivery. Material and Methods: A total of 1600 infertile women in the age group of 25 - 35 years were rec-ruited in the outpatient department of Gynae and Obs-tetrics in Sharif Medical City Hospital from June, 2008 to June, 2009. The patients included in study were the women presenting with either primary or secondary infertility, bad obstetrical history, recurrent miscar-riage, preterm deliveries, and ectopic pregnancies. Combined finding of trans-vaginal ultrasonography and hysterosalpingography were used to diagnose con-genital uterine anomalies. 48 women were diagnosed with congenital uterine anomalies. Eight patients of primary infertility with uterine anomalies were excluded. The retrospective analysis of 40 cases with secon-dary infertility and uterine anomalies was done for reproductive performance. Results: Among 1600 infertile women, the average age of the study group was 30 years ± SD 4.77. Forty eight patients were diagnosed with congenital uterine abnormalities. Among infertile population the most frequent uterine anomalies was bicornuate uterus (45.83%) followed by arcuate uterus (33.33%). The overall frequency of congenital uterine anomalies was 3%. Women with secondary infertility (83.3%) had higher frequency of mullerian duct anomalies in com-parison to women with primary infertility (16.7%). In all these abnormalities, miscarriages (25%) and pre-term delivery (22.5%) were quite common. (P<.0750). The reproductive potential of the bicornuate uterus showed a live birth rate of (67%) and, arcuate uterus of (42.8%). Unicornuate and Septate uterus were associ-ated with poor obstetrical outcome. Conclusion: Congenital uterine anomalies are rela-tively frequent among infertile population and are associated with higher miscarriages and preterm births but may be compatible with normal reproductive out-come.Key Words: Uterine anomalies, preterm birth, mis-carriages.
机译:背景:苗勒氏管畸形描述了由先天性发育或中肾管融合不完全导致的一组先天性异常。在许多患者中,子宫异常与不育,反复流产,早产和其他产科并发症有关,这些并发症增加了围产期的发病率和死亡率,而在其他情况下,这些畸形是无症状的并且具有正常的生殖性能。目的:确定先天性子宫异常妇女的生殖结局。设计:描述性横截面调查。主要结果指标:流产,早产,生态妊娠,足月分娩。材料与方法:从2008年6月至2009年6月在谢里夫医疗城医院妇产科妇产科门诊招募了1600名年龄在25-35岁之间的不育妇女。研究对象为原发性或继发性不育,不良产科史,反复流产,早产和异位妊娠的妇女。经阴道超声和子宫输卵管造影相结合的发现被用于诊断先天性子宫异常。 48名妇女被诊断出患有先天性子宫异常。排除了8例原发性子宫不育症患者。回顾性分析40例继发性不孕和子宫异常的生殖性能。结果:在1600名不育妇女中,研究组的平均年龄为30岁±SD 4.77。四十八名患者被诊断出患有先天性子宫异常。在不育人群中,子宫畸形最常见的是双角子宫(45.83%),其次是弓形子宫(33.33%)。先天性子宫异常的总发生率为3%。与原发性不孕妇女相比,继发性不孕妇女(83.3%)发生苗勒氏管异常的频率更高。在所有这些异常中,流产(25%)和早产(22.5%)非常普遍。 (P <.0750)。双角子宫的生殖潜力显示活产率为(67%),弓状子宫为(42.8%)。子宫角膜和分隔壁与产科预后不良相关。结论:不育人群中先天性子宫异常相对较高,与更高的流产和早产相关,但可能与正常的生殖结果相适应。关键词:子宫异常,早产,流产。

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