Analysis Of Clinical Outcome Of 139 Cases Of Didelphic Uterusin The Third Trimester Ofpregnancy

Objective:Objective to analyze the clinical characteristics,complications during pregnancy and delivery,delivery mode and perinatal outcome of patients withdidelphys uterus combinedwithlate pregnancy,To investigate therelationshipbetween didelphys uterus and adverse pregnancy outcomes,To improve the understanding of didelphys uterus combined with late pregnancy.Methods:The 139 cases ofdidelphys uterus combined with late pregnancy as a case group who met the inclusion and exclusion criteria were selected in Fujian Provincial Maternity and Children's Hospital from January 1,2002 to December 31,2016.and medical records were retrospectively analyzed.1 months from a random cluster of months?March 1,2015 to March 31,2015?,the 1653 cases of pregnant women with normal uterine who had prenatal examination and terminated pregnancy in our hospital were in the third trimester.Frequency matching according to age,being case group:control group=1:2.The 278 pregnant women with normal uterine pregnancy as acontrol group who were eligible for inclusion and exclusion criteria were randomly selectedfrom 1653 normal pregnant women,and the information of electronic medical records was consulted.Grouped according to the mode of delivery,93 cases of didelphys uterus caesarean section were group A,46 cases of didelphys uterus vaginal delivery were group B;89 cases of normal uterine caesarean section were group a,189cases of normal uterus vaginal delivery were group b.58 cases were trial of labor with didelphys uterus,12 cases were transferred to caesarean section constitute of group C;201 cases of normal uterus vaginal trial production and 12 cases were transferred to caesarean section constitute of group c.The SPSS24.0 statistical software was used for t test and chi square test.The clinical characteristics,complications of pregnancy and childbirth,delivery mode and perinatal outcome were analyzed retrospectively.Results:1.General situation comparison:There was no significant difference between the case group and the control group in age,gravidity,parity,prenatal BMIand the rate of infertility treatment?P>0.05?.2.Pregnancy outcome in pregnant women with didelphys uterus:In case group,preterm birth?27.34%vs 7.19%?,breech?21.58 vs 2.52%?,premature rupture of fetal membrane?14.39 vs 3.96%?,and cesarean section?66.91%vs 32.01%?was higher than that of control group,the occurrence rate of full month?72.66%vs 92.81%?and vaginal delivery?74.14%vs 92.54%?was lower than that of control group?P<0.05?.3.The maternal and child outcomes of pregnant women with didelphys uterus:The average birth rate of newborns in the case group was less than that of the control group?37.57±2.88 weeks vs 39.17±1.77weeks?,and the average birth weight was lower than the control group?2746.76±617.25g vs 3243.74±483.00g?.The average birth length was less than the control group?47.23±3.29cm vs 49.48±2.03cm?,and the two groups had statistical significance?P<0.05?.The case group was compared with the control group:postpartum hemorrhage?5.76%vs 1.44%?,fetal growth restriction?2.88%vs 0?,fetal distress?12.23%vs 6.47%?,oligohydramnios?11.51%vs 3.24%?,umbilical cord around neck?27.34%vs 15.47%?,premature infant?25.18%vs 6.47%?,small for gestational age infant?13.67%vs 2.16%?,the incidence of full-term low birth weight?7.19%vs 0.72%?and conversion to neonatal treatment?23.74%vs 2.52%?was high?P<0.05?.4.Vaginal delivery in pregnant women with didelphys uterus:The average birth rate of newborns in the B group?36.31±3.72 weeks?was less than that of b group?39.37±1.58 weeks?.The average birth weight of the newborn?2510.87±757.21g?was lower than that of b group?3279.13±436.88g?.The median total labor time?306.5min?was shorter than that of b group?400.0min?,the difference was statistically significant?P<0.05?.There was no significant difference in the incidence of postpartum hemorrhage between the two groups?P>0.05?.In group B,there were 2cases?4.35%?of neonatal death,1 cases of pregnancy 29⁺³,weight 825g,and Apgar1minutes after birth of 2 minutes,1 cases of pregnancy 30⁺¹ weeks,weight 1180g,Apgar1 minutes after birth of 3 minutes.In group B,15 cases?32.61%?were converted to new pediatric treatment,and premature delivery was the main reason.Conclusions:1.The didelphys uterus can lead to adverse pregnancy outcomes.Premature labor,preterm premature rupture of membranes,and breech presentation increase.The high rate of caesarean section is the main reason for the breech position.2.The didelphys uterus can have an adverse effect on the outcome of mother and child,the incidence of premature birth,postpartum hemorrhage,oligohydramnios,umbilical cord around the neck,fetal distress,fetal growth restriction,small for gestational age infant,full-term low birth weight increased.3.The didelphys uterus pregnancy,for the estimation of fetal weight 1500?2500g,childbirth weeks more than 32 weeks,no other obstetric cesarean section indications,can be closely guardianship,try vaginal delivery.