Maternal and Pediatrics Department, Maggiore Hospital, Bologna, Italy.
Gynecol Obstet Invest. 2011;71(3):183-8. doi: 10.1159/000317266. Epub 2010 Dec 11.
To evaluate the improvement of the term delivery rate after uterine surgery in various uterine malformations.
170 patients were eligible for the present retrospective case series study. Data were weighted for the number of pregnancies observed (n = 218) after surgical intervention, stratified to the number of previous abortions (at least 2) and type of malformation.
Before surgery, the overall term delivery rate was 5.5%. After surgery, the overall term delivery rate was 59% (absolute benefit increase, ABI, was 54.5) and correlated with the number of previous abortions (69.7% ABI = 64.2, 56.5% ABI = 51 and 26.3% ABI = 20.8 for 2, 3-4 and >4 abortions, respectively; p = 0.0008, log-rank test). Data stratified according to uterine malformations yielded the following term delivery rate: 66.7% for T-shaped uterus, 62.8% for septum/partial septum and 55.6% for arcuate uterus (NS, log-rank test). The number of previous abortions and maternal age also affected the term delivery rate. Their effect upon the term delivery rate, expressed as an odds ratio, was 1.73 (95% CI: 1.20-2.49) and 1.11 (95% CI: 1.05-1.18), respectively.
The term delivery rate was about 10-fold higher after surgery. T-shaped uterus surgery yielded the best term delivery rate.
评估各种子宫畸形手术后足月分娩率的提高。
本回顾性病例系列研究纳入了 170 名符合条件的患者。对手术干预后观察到的妊娠次数（n=218）进行了加权，分为既往流产次数（至少 2 次）和畸形类型。
手术前，总足月分娩率为 5.5%。手术后，总足月分娩率为 59%（绝对获益增加，ABI，为 54.5%），与既往流产次数相关（ABI=64.2，ABI=51，ABI=20.8，分别为 2 次、3-4 次和>4 次流产；p=0.0008，对数秩检验）。根据子宫畸形分层的数据得出以下足月分娩率：T 形子宫为 66.7%，纵隔/部分纵隔为 62.8%，弓形子宫为 55.6%（NS，对数秩检验）。既往流产次数和产妇年龄也影响足月分娩率。它们对足月分娩率的影响，用优势比表示，分别为 1.73（95%CI：1.20-2.49）和 1.11（95%CI：1.05-1.18）。
手术后足月分娩率提高了约 10 倍。T 形子宫手术的足月分娩率最高。
