| Background and ObjectiveUterus malformation is the most common reproductive tract deformity which caused by the dysfunction of the urogenital ridge differentiation when embryo grows from6to17weeks.Uterus malformation is always combined with the freak of urinary or digestive system,especially urinary system malformation.Because of the abnormal anatomy, the women with uterine malformations have a lower natural pregnancy rate and higher rates of spontaneous abortion and preterm delivery after pregnancy than that with normal uterus.Even more,it is harmful to the mothers and babies during their gestation,which is also easy to cause pregnancy complications,so it pertains to high risk pregnancy.While the reasonable operation can restore the anatomy and improve the outcomes.The objective is to analysis the pregnancy outcomes of94cases with uterine malformations.MethodsThe clinical date of94cases with uterine malformations who treated in the department of obstetrics and gynecology, the second affiliated hospital of Zhengzhou University from January2008to January2012were analyzed restrospectively. All the women were aged from19to44years and the average age was (26.4±4.9) years.All the women were diagnosed by ultrasound or MRI or hysteroscope and (or) laparoscope or were found in the previa cesarean section. All the women and their husbands didn’t have the other problems which cause infertility.41of the94patients were operated by hysteroscope and (or) laparoscope. SPSS17.0was used to analyze the data by using Fisher’s Exact Test and Chisquare Test. α=0.05was considered to be as the detection standard.Results1There were94cases with uterine malformations among the25200cases.Among them, partial septate uterus was31cases,didelphic uterus in16cases, bicornute uterus in12cases, entire septate uterus in9cases,uniomis uterus in7cases,rudimentary horn of uterus in3cases,saddle form uterus in1cases.The patients with didelphic uterus,unimis uterus and rudimentary were combined with absence of kidney on side.211of the94cases were primary sterility, the rest83cases had1～8times fetation. There were211fetation among the other83cases,the rate of spontaneous abortion was69.2%(146/211), partial septate uterus had the highest rate of spontaneous abortion than the others, preterm delivery was7.6%(l6/211) and term delivery was23.2%(49/211). No differrence were formed between every kind of malformed uterus in preterm delivery and term delivery(P>0.05).3The rates of breech presentation and PROM were27.7%(18/65);placental previa and secondary uterine inertia were10.8%(7/65) and6.2%(4/65); respectively cesarean section rate was81.5%(53/65). Most of them have anomalies.No differrence were formed between ervery kind of malformed uterus during the perinatal period (P>0.05).441of the94cases had received uterine cosmetic surgery with hysteroscope and (or) laparoscope.There were30cases with partial septate uterus(8were with endometrial polyps),7cases with entire septate uterus(2were with endometrial polyps),1case with rudimentary horn of uterus complicated with endomentriosis and3cases with bicornute uterus. Follow-up survey showed that5of11primary sterlity patients were pregnant,the conception rate was45.5%(5/11).There were8gestation among the5cases,4gestion were spontaneous abortion and the other4gestation were term delivery.28of30cases with the recurrent abortion conceived,the conception rate was93.3%(28/30).Among their40gestation,14were spontaneous abortion,24were term delivery,2were in family way.So its spontaneous abortion rate were dropped from100%to35%(14/40),and the rate of term delivery rised to60.0%(24/40).Conclusion1There are many kinds of uterus malformation,while partial septate uterus and didelphic uterus are more common.Some of them are combined with urinary system deformity.2The patients with uterine anomalies have higher rates of spontaneous abortion.3Pregnant women with malformed uterus have more anomalies during the perinatal period.4Uterine plastic operation by hysteroscope and (or) laparoscope technique can improve the outcomes of pregnancy patients who with uterine malformation. |
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