Braun Petra, Grau Francisco Vercher, Pons Raúl Mut, Enguix Daniel Perez
Maternal Department of Radiology, La Fe Hospital, Avenida Campanar 21, 46009 Valencia, Spain.
Eur J Radiol. 2005 Feb;53(2):274-9. doi: 10.1016/j.ejrad.2004.04.004.
Mullerian duct anomalies are an uncommon but often a treatable cause of infertility.
From January 2002 until November 2003, a total of 705 hysterosalpingographies were realised of which 658 were analysed retrospectively in order to determine the importance of uterine malformations in infertile and sterile patients. In ten cases, the results of hysterosalpingography were compared with hysteroscopy and laparoscopy.
The frequency of uterine malformations in infertile and sterile women was 10%. In this population, arcuate uterus (57.6%) was the most common malformation, followed by subseptate uterus (18.2%), uterus bicornis unicollis (10.6%), uterus bicornis bicollis (3.0%), septate uterus (6.1%), unicornuate uterus (3.0%) and unicornuate uterus with double vagina (1.5%).
Our bibliographic research confirmed that arcuate uterus is the most frequent congenital malformation, but in gestations it does not show a significantly reduced live birth rate. Nevertheless, the septate uterus presents an important decrease of live birth rate that can be improved significantly by doing hysteroscopic metroplasty. As this is a completely different surgical intervention compared to bicornuate uterus, a correct diagnosis is very important. Differentiation of these two malformations is quite difficult by hysterosalpingographic exploration, wherefore an additional exploration by means of endovaginal or three-dimensional ultrasound is recommended.
苗勒管异常是导致不孕的一个不常见但通常可治疗的原因。
2002年1月至2003年11月，共进行了705例子宫输卵管造影术，其中658例进行回顾性分析，以确定子宫畸形在不孕和不育患者中的重要性。在10例病例中，将子宫输卵管造影术的结果与宫腔镜检查和腹腔镜检查的结果进行了比较。
不孕和不育女性中子宫畸形的发生率为10%。在这一人群中，弓形子宫（57.6%）是最常见的畸形，其次是不完全纵隔子宫（18.2%）、单角子宫（10.6%）、双角子宫（3.0%）、纵隔子宫（6.1%）、单角子宫（3.0%）和伴有双阴道的单角子宫（1.5%）。
我们的文献研究证实，弓形子宫是最常见的先天性畸形，但在妊娠中其活产率并未显著降低。然而，纵隔子宫的活产率显著下降，通过宫腔镜子宫成形术可显著提高。由于这与双角子宫的手术干预完全不同，正确的诊断非常重要。通过子宫输卵管造影检查很难区分这两种畸形，因此建议通过经阴道或三维超声进行进一步检查。
