摘要：
目的 分析不完全纵隔子宫中晚期妊娠的声像图特征及对胎位、胎盘、羊水和胎儿的影响.方法 选取中国人民解放军第454医院自2013年9月至2016年9月收治的90例不完全纵隔子宫中晚期妊娠妇女作为观察组,按照病历号顺序随机选择87例同期非纵隔子宫孕妇作为对照组,采用超声检查对观察组确诊后,对两组孕妇定期给予超声随访直至胎儿出生,对比其妊娠结局.结果 超声观察可见胎儿的躯体大部分位于较大宫腔的一侧,而胎儿的部分肢体或少部分胎儿躯体位于较小宫腔侧.对该组产妇进行了随访追踪可见,其中24例产妇为正常分娩,占26.67％,另有66例产妇为剖宫产,占73.33％,产前给予影像学检查可见有86例表现为胎位异常,占95.56％,其中46例为横位,占51.11％,40例为臀位,占44.44％,出现胎盘增厚变形31例,占34.44％.观察组与对照组相比正常分娩率低,剖宫产率高,胎位异常率高,差异具有统计学意义(x2值分别为6.23、5.88、4.78,均P＜0.05).结论 在不完全纵隔子宫畸形妇女中晚期妊娠期间,给予超声检查能够获得较高的准确率,对胎儿发育情况进行有效的监测,为后续生产方式的选择提供合理依据.%Objective To analyze ultrasonographic characteristics of incomplete mediastinal uterus in middle and late pregnancy and their influence on fetal position,placenta,amniotic fluid and fetus.Methods Ninety pregnant women in middle and late pregnancy with incomplete mediastinal uterus admitted in the 454th Hospital of PLA from September 2013 to September 2016 were selected into observation group,and 87 pregnant women without septate uterus were chosen randomly according to case number at the same time as control group.Patients in the observation group were confirmed by ultrasonographic diagnosis.Women in both groups were followed up with ultrasonographic check until delivery and their pregnancy outcomes were compared.Results Ultrasonic image showed that most part of fetal body was in larger uterine cavity and part limbs or small part of fetal body was in smaller cavity.Follow-up of patients in the observation group found that 24 women experienced normal childbirth,accounting for 26.67％,and 66 cases received cesarean section,accounting for 73.33％.Prenatal ultrasonic check detected 86 cases with abnormal fetal position,accounting for 95.56％,of which 46 cases were transverse position,accounting for 51.11％,40 cases breech presentation,accounting for 44.44％,and 31 cases with placental thickening deformation,accounting for 34.44％.Compared with control group,observation group had lower normal delivery rate and higher rates of cesarean section and abnormal fetal position,and differences were statistically significant (x2 value was 6.23,5.88 and 4.78,respectively,all P ＜ 0.05).Conclusion Ultrasound examination for pregnant women with incomplete mediastinal uterus in middle and late pregnancy has high diagnostic accuracy and provides effective monitoring on fetal development situation and reasonable basis for delivery mode selection.
