剖腹产手术中先天性子宫畸形的发生率和类型:前瞻性队列研究

Mridula Patil, Vrinda Patil
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摘要

:先天性子宫畸形是由于穆勒氏管发育不良造成的。它们会导致不良的生殖后果,如反复流产、早产、胎位不正和不孕。先天性子宫畸形的发病率为 5-7%。目的:了解剖腹产手术中先天性子宫畸形的发生率和类型。这是一项前瞻性队列研究,于 2020 年 8 月至 2021 年 7 月在印度达尔瓦德的 SDM 医学院和医院进行。2932 名接受剖腹产手术的妇女参与了这项研究。对子宫进行了全面检查。注意到子宫异常的类型:剖腹产手术中有 22 例先天性子宫异常(CUA)。先天性子宫畸形的发病率为 0.75%。在子宫畸形的产妇中,流产(27%)、先兆子痫(31.8%)、胎位不正(31.8%)、胎儿生长受限(9%)和早产剖腹产(40.9%)的发生率都有所增加。最常见的子宫畸形类型是单角子宫(31.8%),其次是隔膜子宫(27.2%)、弧形子宫(22.7%)和双角子宫(18.1%)。结果最差的是子宫纵隔和单角子宫:剖腹产为诊断先天性子宫畸形提供了机会。这些信息可用于规划她们未来的生育生活。在胎儿和胎盘娩出后,必须对子宫进行探查,以寻找子宫畸形,并记录在案。
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Frequency and types of congenital uterine anomalies during caesarean section: A prospective cohort study
: Congenital uterine anomalies are due to mal-development of the mullerian ducts. They can lead to adverse reproductive outcomes like recurrent miscarriage, preterm birth, foetal malpresentation and subfertility. Prevalence of congenital uterine anomalies is 5-7%. To find the frequency and types of congenital uterine anomalies during caesarean section. This is a prospective cohort study done at SDM College of Medical Sciences and Hospital, Dharwad, India from August 2020 to July 2021. 2932 women undergoing caesarean section participated in the study. The uterus was examined thoroughly. The type of uterine anomaly was noted. : There were 22 cases of congenital uterine anomalies (CUAs) during caesarean section. Prevalence of CUA was 0.75%. There was increased incidence of miscarriage(27%), pre-eclampsia (31.8%), foetal malpresentation (31.8%), foetal growth restriction (9%) and preterm caesarean section (40.9%) among women with a uterine anomaly. Commonest type of CUA was unicornuate uterus (31.8%), followed by septate (27.2%), arcuate (22.7%) and bicornuate uterus (18.1%). Poorest outcomes were seen with septate and unicornuate uteri.: Caesarean section provides an opportunity to diagnose congenital uterine anomalies. This information can be used to plan their future reproductive life. Exploring the uterus to look for uterine anomalies after delivery of the fetus and placenta has to be done and documented.
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