Ugboaja J O, Oguejiofor C B, Igwegbe A O, Oranu E O
Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
Department of Obstetrics and Gynaecology, University of Portharcout Teaching Hospital, Port Harcourt, Nigeria.
Niger J Clin Pract. 2019 Jan;22(1):9-15. doi: 10.4103/njcp.njcp_404_17.
Intrauterine lesions are important causes of infertility. This study aims to evaluate the abnormal findings at hysteroscopy among infertile women seen in 2 new Fertility/Gynaecological Endoscopy units in Nigeria.
A prospective study of 159 infertile women who had diagnostic hysteroscopy in Nnamdi Azikiwe University Teaching hospital Nnewi and Holy Rosary Specialist Hospital, Onitsha to evaluate the intrauterine lesions seen. Data analysis was done with STATA software, version 12.0 SE (Stata Corporation, TX, USA).
Secondary infertility was the major type of infertility seen in 56.6% (n = 91) of cases and the mean duration of infertility was 4.3+/- 2.8 years. The indication for hysteroscopy was routine evaluation for infertility in 83.6% cases (n = 133). One hundred and twelve (70.4%) of the women had abnormal findings at hysteroscopy. The lesions detected were intrauterine adhesions (47.8%; n = 76), endometrial polyps (17.6%; n = 28), submucous fibroids (11.9%; n = 19) and mullerian duct abnormalities (10.7%; n = 17). Other findings were lost intrauterine copper devices (IUCD; 6.3%, n = 10), embedded fetal bone (2.5%; n = 4) and incarcerated omentum (1.9%; n = 3). Intrauterine adhesions were mainly moderate (40.8%; n = 31) and mild (34.2, n = 26) in severity while the submucous fibroids were mostly of type 0 (63.2%; n = 12). The commonest Mullerian abnormality seen was arcuate uterus (41.2%; n = 7).
There was a high prevalence of abnormal findings on hysteroscopy among the studied women mostly intrauterine adhesions, endometrial polyps and submucous fibroids. These findings indicate a need to incorporate hysteroscopy in the routine evaluation of female infertility in the region.
子宫内病变是导致不孕的重要原因。本研究旨在评估在尼日利亚两家新的生育/妇科内窥镜检查单位就诊的不孕女性宫腔镜检查的异常结果。
对在恩纳姆迪·阿齐克韦大学教学医院纽维分院和奥尼查圣母玫瑰专科医院接受诊断性宫腔镜检查的159名不孕女性进行前瞻性研究，以评估所见的子宫内病变。使用STATA软件12.0 SE版本（美国德克萨斯州Stata公司）进行数据分析。
继发性不孕是主要的不孕类型，见于56.6%（n = 91）的病例，平均不孕持续时间为4.3±2.8年。宫腔镜检查的指征在83.6%的病例（n = 133）中是对不孕进行常规评估。112名（70.4%）女性在宫腔镜检查时有异常发现。检测到的病变有子宫内粘连（47.8%；n = 76）、子宫内膜息肉（17.6%；n = 28）、黏膜下肌瘤（11.9%；n = 19）和苗勒管异常（10.7%；n = 17）。其他发现有丢失的宫内节育器（IUCD；6.3%，n = 10）、嵌入的胎儿骨骼（2.5%；n = 4）和嵌顿的大网膜（1.9%；n = 3）。子宫内粘连主要为中度（40.8%；n = 31）和轻度（34.2%，n = 26），而黏膜下肌瘤大多为0型（63.2%；n = 12）。最常见的苗勒管异常是弓形子宫（41.2%；n = 7）。
在所研究的女性中，宫腔镜检查异常结果的患病率很高，主要是子宫内粘连、子宫内膜息肉和黏膜下肌瘤。这些发现表明有必要将宫腔镜检查纳入该地区女性不孕的常规评估中。
