Department of Obstetrics and Gynecology, Nagoya City University, Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Japan.
Semin Reprod Med. 2011 Nov;29(6):514-21. doi: 10.1055/s-0031-1293205. Epub 2011 Dec 8.
Women with recurrent pregnancy loss have a 3.2 to 6.9% likelihood of having a major uterine anomaly and a 1.0 to 16.9% chance of having an arcuate uterus. Bicornuate and septate uterine have a negative impact on reproductive outcomes and are associated with subsequent euploid miscarriage. The impact of an arcuate uterus on pregnancy outcome remains unclear. There are no definitive criteria to distinguish among the arcuate, septate, and bicornuate uteri. The American Fertility Society classification of Müllerian anomalies is the most common standardized classification of uterine anomalies. According to estimates, 65 to 85% of patients with bicornuate or septate uteri have a successful pregnancy outcome after metroplasty. However, 59.5% of the patients with such anomalies have a successful subsequent pregnancy without surgery, with a cumulative live birthrate of 78.0%. There is no case-control study to compare live birthrates in women who had surgery compared with those who did not. Strict criteria to distinguish between the bicornuate and septate uterus should be established. Further study is needed to confirm the benefits of metroplasty.
反复妊娠丢失的女性发生主要子宫异常的可能性为 3.2%至 6.9%，发生弓形子宫的可能性为 1.0%至 16.9%。双角子宫和纵隔子宫对生殖结局有负面影响，并与随后的整倍体流产有关。弓形子宫对妊娠结局的影响尚不清楚。目前尚无明确标准来区分弓形子宫、纵隔子宫和双角子宫。美国生殖医学协会的 Müllerian 异常分类是最常用的子宫异常标准化分类。据估计，65%至 85%的双角或纵隔子宫患者在子宫整形术后可获得成功妊娠结局。然而，59.5%的此类异常患者未经手术即可成功获得后续妊娠，累积活产率为 78.0%。没有病例对照研究来比较手术和未手术患者的活产率。应建立严格的标准来区分双角子宫和纵隔子宫。需要进一步的研究来证实子宫整形术的益处。
