Sørensen S S
Department of Gynecology K, Bispebjerg Hospital, Copenhagen, Denmark.
Int J Fertil. 1987 Nov-Dec;32(6):445-52.
In a prospective study of 28 consecutive patients with oligomenorrhea, two had uterus didelphys, and the incidence of mild müllerian anomalies was 50.0%, assessed by hysterosalpingography (HSG). The objects of the study were (1) to confirm these müllerian anomalies hysteroscopically, (2) to assess the predictive value of an abnormal and a normal fundal contour on the HSG, and (3) to find anamnestic, chromosomal, or hormonal characteristics, if any, for women with oligomenorrhea and müllerian anomalies. Twelve patients underwent HSG followed by hysteroscopy, at which a septum or fundal convexity was confirmed in six out of seven patients in whom HSG had shown a mild to moderate indentation of the fundus, but showed no such sign in any of the five patients in the control group in whom the uterine contours had been normal on the HSG (P less than .01). There were no evident anamnestic, chromosomal, or hormonal characteristics for women having uterine developmental anomalies and oligomenorrhea, but there was a major or minor shift in certain androgenic metabolites in some of the patients in this group. It is concluded that HSG seems of great value in diagnosing uterine septa, but hysteroscopy afforded more precise information concerning the degree of fundal anomaly. Longitudinal, more standardized studies are needed for further elucidation of the etiology of the oligomenorrhea in these patients.
在一项对28例连续的月经过少患者的前瞻性研究中，有2例双子宫，子宫输卵管造影（HSG）评估显示轻度苗勒氏管异常的发生率为50.0%。该研究的目的是：（1）通过宫腔镜检查确认这些苗勒氏管异常；（2）评估HSG上异常和正常宫底轮廓的预测价值；（3）找出月经过少且有苗勒氏管异常的女性的既往史、染色体或激素特征（若有的话）。12例患者先进行了HSG检查，随后接受了宫腔镜检查，其中7例HSG显示宫底有轻度至中度压迹的患者中有6例在宫腔镜检查时确认有纵隔或宫底凸起，但HSG显示子宫轮廓正常的对照组5例患者中均未出现此类征象（P<0.01）。有子宫发育异常和月经过少的女性没有明显的既往史、染色体或激素特征，但该组部分患者的某些雄激素代谢产物有或多或少的变化。结论是，HSG在诊断子宫纵隔方面似乎很有价值，但宫腔镜检查能提供有关宫底异常程度更精确的信息。需要进行更具纵向性、更标准化的研究，以进一步阐明这些患者月经过少的病因。
