原发性不孕患者及复发性流产患者宫腔镜切除子宫纵隔的组织学结构与血管分布

Histological Structure and Vascularity of Hysteroscopically Removed Uterine Septa in Patients With Primary Infertility and Patients With Recurrent Pregnancy Loss.

作者信息

Abdel Moety Ghada Abdel Fattah, Gaafar Hassan Mostafa, Shawki Osama, Faisal Mohamed

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

J Minim Invasive Gynecol. 2016 Jan;23(1):66-71. doi: 10.1016/j.jmig.2015.08.880. Epub 2015 Aug 28.

DOI:10.1016/j.jmig.2015.08.880

PMID:26319797

Abstract

OBJECTIVE

To examine the histological structure and vascularity of uterine septa in patients with unexplained primary infertility and patients with recurrent pregnancy loss (RPL).

DESIGN

Case-control study (Canadian Task Force classification II-2).

SETTING

Kasr Al Aini Hospital, Cairo University, Egypt.

PATIENTS AND INTERVENTIONS

A total of 41 patients with uterine septa presenting with either unexplained primary infertility or RPL underwent 3-dimensional (3D) and power Doppler (PD) ultrasound to calculate the septum volume, septal vascularization index (VI), and myometrial VI. Hysteroscopically removed septa were examined histologically for myometrial and fibrous tissue content.

MEASUREMENTS AND MAIN RESULTS

Septal characteristics differed between the primary infertility group (24 patients) and the RPL group (17 patients). Mean septal VI was significantly higher in the RPL group compared with the infertility group (18.39% ± 7.57% vs 11.67% ± 4.56%; p = .003), as was septal myometrial area (20.74% ± 5.97% vs 13.57% ± 5.55%; p < .001). In both groups, septal VI was strongly correlated with myometrial VI and myometrial content, but not with fibrous tissue content.

CONCLUSION

Uterine septa of patients with RPL are more vascularized and contain more muscular tissue compared with those of patients with primary unexplained infertility.

摘要

目的

研究不明原因原发性不孕患者和复发性流产（RPL）患者子宫纵隔的组织结构和血管分布情况。

设计

病例对照研究（加拿大工作组分类II-2）。

地点

埃及开罗大学卡斯尔·艾尼医院。

患者与干预措施

共41例患有子宫纵隔的患者，这些患者表现为不明原因原发性不孕或复发性流产，接受了三维（3D）和能量多普勒（PD）超声检查，以计算纵隔体积、纵隔血管化指数（VI）和肌层VI。对经宫腔镜切除的纵隔进行组织学检查，以确定肌层和纤维组织含量。

测量指标与主要结果

原发性不孕组（24例患者）和复发性流产组（17例患者）的纵隔特征存在差异。与不孕组相比，复发性流产组的平均纵隔VI显著更高（18.39%±7.57% vs 11.67%±4.56%；p = 0.003），纵隔肌层面积也是如此（20.74%±5.97% vs 13.57%±5.55%；p < 0.001）。在两组中，纵隔VI与肌层VI和肌层含量密切相关，但与纤维组织含量无关。