Martínez Reveles M, Salazar López-Ortíz C G, Gaviño Gaviño F, Castro López J L, Mondragón Alcocer H L
Departamento de Reproducción Asistida, Instituto Nacional de Perinatología, D.F.
Ginecol Obstet Mex. 1999 Jan;67:4-8.
Determine the type and the possibility of corrective surgery, reproductive results of infertility patients with Müllerian malformations. The clinic and the laparoscopic and hysteroscopic evaluation were performed to 40 patients with Müllerian anomalies and infertility history analyzing the reproductive results. The uterine septum was present in 23/40 patients (57.5%), bicornual uterus in 6/40 (15%), didelfus uterus 5/40 (12.5%), arcuate uterus 4/40 (10%), unicorn uterus 2/40 (5%). After septum resection we had 13 pregnancies (56.5%). 2 abortions, 4 already delivered and 7 continue normal evolution with on twin case. Strassman metroplasty by laparotomy was performed in 4 cases of bicornual uterus achieving pregnancy in two cases. In one didelfus uterus, a salpingoclasy of the smaller horn was done as an alternative. Of the arcuated uterus, the small septum was removed. Of the unicorn uterus, one pregnancy was lost in the first trimester and the other one reach the term date. Our data show that the endoscopic procedures can perform the correct diagnosis of the Müllerian anomalies and of course the best surgical treatment improving the fertility rates.
确定患有苗勒管畸形的不孕患者矫正手术的类型和可能性以及生殖结果。对40例有苗勒管异常和不孕史的患者进行了临床检查以及腹腔镜和宫腔镜评估，分析其生殖结果。40例患者中，存在子宫纵隔的有23例（57.5%），双角子宫6例（15%），双子宫5例（12.5%），弓形子宫4例（10%），单角子宫2例（5%）。纵隔切除术后有13例妊娠（56.5%）。2例流产，4例已分娩，7例继续正常妊娠过程，其中1例为双胎。对4例双角子宫患者行开腹Strassman子宫成形术，2例妊娠。对于1例双子宫，对较小的角进行了输卵管结扎作为替代方案。对于弓形子宫，切除了小纵隔。对于单角子宫，1例在孕早期流产，另1例足月分娩。我们的数据表明，内镜手术可以对苗勒管异常进行正确诊断，当然也能进行最佳的手术治疗，提高生育率。
