Mastrolia Salvatore Andrea, Baumfeld Yael, Hershkovitz Reli, Yohay David, Trojano Giuseppe, Weintraub Adi Y
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, School of Medicine, Ben Gurion University of the Negev, 151 Rager Boulevard, Beer Sheva, 84101, Israel.
Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, University of Milano Bicocca, Monza, Italy.
Arch Gynecol Obstet. 2018 Apr;297(4):919-926. doi: 10.1007/s00404-018-4663-2. Epub 2018 Feb 1.
The purpose of our study was to explore maternal and fetal outcomes in the second and third trimester in women with uterine malformations.
This was a retrospective population-based cohort study including women with a diagnosis of uterine malformation arised from workup for infertility or recurrent pregnancy loss, was accidental during pregnancy, or was noticed at the time of cesarean delivery.
A total of 280,721 pregnancies met the inclusion criteria and were divided into two study groups: (1) pregnancies in women with uterine malformations (n = 1099); and (2) controls (n = 279,662). The rate of women presenting uterine malformations was 0.39%. The prevalence of cervical os insufficiency was significantly higher in women with a uterine malformation than in the control group (3.6 vs. 0.4%, p < 0.001). A multivariate analysis, performed to evaluate risk factors for cervical insufficiency in women with uterine malformations. Mullerian anomalies (OR 6.19, 95% CI 4.41-8.70, p < 0.001), maternal age (OR 1.05, 95% CI 1.04-1.06, p < 0.001), recurrent abortions (OR 12.93, 95% CI 11.43-14.62, p < 0.001), and ethnicity (OR 2.86, 95% CI 2.454-3.34, p < 0.001) were found to be independently associated with the development of cervical insufficiency.
Uterine anomalies have a strong association with cervical insufficiency. Women with uterine anomalies have an increased risk to develop pregnancy complications that arise from a loss in cervical function during the midtrimester or early third trimester.
我们研究的目的是探讨子宫畸形女性在孕中期和孕晚期的母胎结局。
这是一项基于人群的回顾性队列研究，纳入因不孕或复发性流产检查、孕期偶然发现或剖宫产时发现而诊断为子宫畸形的女性。
共有280721例妊娠符合纳入标准，分为两个研究组：（1）子宫畸形女性的妊娠（n = 1099）；（2）对照组（n = 279662）。子宫畸形女性的发生率为0.39%。子宫畸形女性宫颈机能不全的患病率显著高于对照组（3.6%对0.4%，p < 0.001）。进行多因素分析以评估子宫畸形女性宫颈机能不全的危险因素。发现苗勒氏管异常（比值比6.19，95%可信区间4.41 - 8.70，p < 0.001）、产妇年龄（比值比1.05，95%可信区间1.04 - 1.06，p < 0.001）、复发性流产（比值比12.93，95%可信区间11.43 - 14.62，p < 0.001）和种族（比值比2.86，95%可信区间2.454 - 3.34，p < 0.001）与宫颈机能不全的发生独立相关。
子宫异常与宫颈机能不全密切相关。子宫异常的女性在孕中期或孕晚期早期因宫颈功能丧失而发生妊娠并发症的风险增加。
