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完全性子宫纵隔宫腔镜切除术后经阴道分娩双宫颈及纵向阴道纵隔的产时切除术:一例报告

Intrapartal resection of the double cervix and longitudinal vaginal septum after hysteroscopic resection of the complete uterine septum, resulting in a term vaginal delivery: A case report.

作者信息

Marton Ingrid, Habek Dubravko, Prka Matija, Marffy Iva, Pavlovic Milan

机构信息

Department of Obstetrics and Gynecology, Zagreb University School of Medicine, Clinical Hospital "Sveti Duh", Sveti Duh 64, Zagreb, Croatia.

Croatian Catholic University, Zagreb, Ilica 242, Zagreb, Croatia.

出版信息

Case Rep Womens Health. 2016 Aug 12;11:1-4. doi: 10.1016/j.crwh.2016.08.001. eCollection 2016 Jul.

DOI:10.1016/j.crwh.2016.08.001
PMID:29593983
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5863028/
Abstract

OBJECTIVE

To report a rare uterine anomaly of a septate uterus, double cervix and double vagina in patient who conceived spontaneously and delivered vaginaly.

DESIGN

Case report.

SETTING

Department of Obstetrics and Gynecology, Zagreb University School of Medicine, Clinical Hospital "Sveti Duh", Zagreb, Croatia.

PATIENTS

A 34-year-old nulligravida who underwent clinical, radiological, surgical and intrapartal workup.

INTERVENTIONS

Clinical examination and intrapartal surgical resection of vaginal septum followed by vaginal delivery.

MAIN OUTCOME MEASURES

Description and treatment for a rare Müllerian anomaly and a subsequent literature search.

RESULTS

Successful intrapartal resection of longitudinal vaginal septum and double cervix followed by vaginal delivery without complication.

CONCLUSIONS

Reconstructive surgical procedures may be considered for providing spontaneous pregnancies and intrapartal surgical technique could be taken into consideration in order to prevent unnecessary cesarean sections, upon strict estimation of the obstetrician.

摘要

目的

报告一例罕见的子宫畸形病例,该患者为纵隔子宫、双宫颈和双阴道,自然受孕并经阴道分娩。

设计

病例报告。

地点

克罗地亚萨格勒布“圣杜赫”临床医院,萨格勒布大学医学院妇产科。

患者

一名34岁未孕女性,接受了临床、放射学、手术及分娩期检查。

干预措施

临床检查及分娩期经阴道手术切除阴道纵隔,随后经阴道分娩。

主要观察指标

描述并治疗一种罕见的苗勒管畸形,并进行后续文献检索。

结果

分娩期成功切除纵向阴道纵隔和双宫颈,随后经阴道分娩,无并发症。

结论

在产科医生严格评估后,可考虑采用重建性外科手术以实现自然受孕,同时可考虑采用分娩期手术技术以避免不必要的剖宫产。

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引用本文的文献

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Treatment of septate uterus.子宫纵隔的治疗。
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本文引用的文献

1
The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies.ESHRE/ESGE 关于女性生殖道先天性畸形分类的共识。
Hum Reprod. 2013 Aug;28(8):2032-44. doi: 10.1093/humrep/det098. Epub 2013 Jun 14.
2
Accuracy of three-dimensional ultrasonography in differential diagnosis of septate and bicornuate uterus compared with office hysteroscopy and pelvic magnetic resonance imaging.三维超声在鉴别诊断纵隔子宫和双角子宫与门诊宫腔镜和盆腔磁共振成像的准确性比较。
J Minim Invasive Gynecol. 2012 Jan-Feb;19(1):101-6. doi: 10.1016/j.jmig.2011.08.724. Epub 2011 Oct 20.
3
Müllerian anomalies "without a classification": from the didelphys-unicollis uterus to the bicervical uterus with or without septate vagina.“未分类”的苗勒管异常:从双子宫单宫颈到有或无纵隔阴道的双宫颈子宫。
Fertil Steril. 2009 Jun;91(6):2369-75. doi: 10.1016/j.fertnstert.2008.01.079. Epub 2008 Mar 25.
4
Surgical correction of rare Müllerian anomalies and spontaneous pregnancies: a case report.罕见苗勒管异常的手术矫正与自然妊娠:一例报告
Fertil Steril. 2008 Mar;89(3):723.e13-6. doi: 10.1016/j.fertnstert.2007.04.003. Epub 2007 Oct 24.
5
Septate uterus with cervical duplication and a longitudinal vaginal septum: a müllerian anomaly without a classification.伴有宫颈重复及阴道纵隔的纵隔子宫:一种无分类的苗勒管异常。
Fertil Steril. 2006 Feb;85(2):494.e9-10. doi: 10.1016/j.fertnstert.2005.07.1324.
6
The diagnosis and reproductive outcome after surgical treatment of the complete septate uterus, duplicated cervix and vaginal septum.完全纵隔子宫、双宫颈及阴道纵隔手术治疗后的诊断及生殖结局
Am J Obstet Gynecol. 2004 Jun;190(6):1669-75; discussion 1675-8. doi: 10.1016/j.ajog.2004.02.046.
7
Septate uterus with cervical duplication and longitudinal vaginal septum: a report of five new cases.伴有宫颈重复和阴道纵隔的纵隔子宫:5例新病例报告
Fertil Steril. 2004 Apr;81(4):1133-6. doi: 10.1016/j.fertnstert.2003.08.051.
8
Septate uterus with cervical duplication: a full-term delivery after resection of a vaginal septum.伴有宫颈重复的纵隔子宫:阴道纵隔切除术后足月分娩。
Fertil Steril. 2004 Apr;81(4):1125-6. doi: 10.1016/j.fertnstert.2003.12.015.
9
Female genital anomalies affecting reproduction.影响生殖的女性生殖器异常。
Fertil Steril. 2002 Nov;78(5):899-915. doi: 10.1016/s0015-0282(02)03368-x.
10
Double cervix and vagina with septate uterus: an uncommon müllerian malformation.双宫颈、双阴道伴纵隔子宫:一种罕见的苗勒管畸形。
Obstet Gynecol. 2001 Nov;98(5 Pt 2):982-5. doi: 10.1016/s0029-7844(01)01559-9.