Sawada Masaaki, Kakigano Aiko, Matsuzaki Shinya, Takiuchi Tsuyoshi, Mimura Kazuya, Kumasawa Keiichi, Endo Masayuki, Ueda Yutaka, Yoshino Kiyoshi, Kimura Tadashi
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
J Obstet Gynaecol Res. 2018 Jun;44(6):1080-1086. doi: 10.1111/jog.13622. Epub 2018 Mar 8.
Previous studies have shown adverse obstetric outcomes of the laparoscopic resection of a rudimentary horn. Our study aimed to investigate the obstetric outcome in our institution and to review previous studies.
Using a retrospective analysis, data were reviewed from singleton pregnancies with maternal uterine anomalies at a medical center in Osaka, Japan, between January 2011 and March 2016. The uterine anomaly cases were divided into a 'postlaparoscopic resection of the rudimentary horn' group (study group) and an 'other uterine anomalies' (bicornuate uterus, uterine didelphys and unicornuate uterus) group (control group). Primary outcomes of interest were differences in obstetric outcomes, such as spontaneous preterm birth rate, small for gestational age (SGA) infant rate and hypertensive disorders of pregnancy (HDP) rate between the study and the control group, and the secondary outcome of interest was mode of delivery in the study group.
Data from 40 deliveries were included in the study (7 deliveries: study group, 33 deliveries: control group). No significant difference was observed between the two groups in terms of either mean gestational weeks at delivery (36.4 weeks vs 37.1 weeks; P = .38), cesarean delivery rate (57.1% vs 57.5%; P = 1.0), SGA infant rate (<10th percentile) (0% vs 24.2%; P = .31) and HDP rate (0.0% vs 3.0%; P = 1.0). Three of seven cases with postlaparoscopic resection of the rudimentary horn were able to deliver vaginally without complications.
Our study shows that the obstetric outcome observed in the study group was similar to that observed in the control group.
既往研究显示腹腔镜切除残角子宫存在不良产科结局。本研究旨在调查我院的产科结局并回顾既往研究。
采用回顾性分析,对2011年1月至2016年3月期间日本大阪某医疗中心单胎妊娠合并子宫畸形的病例资料进行回顾。子宫畸形病例分为“腹腔镜下残角子宫切除术后”组(研究组)和“其他子宫畸形”(双子宫、双子宫体和单角子宫)组(对照组)。主要关注的结局是研究组与对照组产科结局的差异,如自然早产率、小于胎龄儿(SGA)发生率和妊娠期高血压疾病(HDP)发生率,次要关注的结局是研究组的分娩方式。
本研究纳入了40例分娩的数据(7例:研究组,33例:对照组)。两组在平均分娩孕周(36.4周 vs 37.1周;P = 0.38)、剖宫产率(57.1% vs 57.5%;P = 1.0)、SGA发生率(<第10百分位数)(0% vs 24.2%;P = 0.31)和HDP发生率(0.0% vs 3.0%;P = 1.0)方面均未观察到显著差异。腹腔镜下残角子宫切除术后的7例病例中有3例能够经阴道分娩且无并发症。
我们的研究表明,研究组观察到的产科结局与对照组相似。