Department of Obstetrics & Gynecology, Columbia University Medical Center, Fertility Center, 5 Columbus Circle, PH, New York, New York, USA.
Department of Obstetrics & Gynecology, Columbia University Medical Center, Fertility Center, 5 Columbus Circle, PH, New York, New York, USA.
Semin Perinatol. 2019 Mar;43(2):74-79. doi: 10.1053/j.semperi.2018.12.003. Epub 2018 Dec 20.
To review the current understanding of the role the uterus plays in recurrent pregnancy loss.
Congenital and acquired uterine abnormalities are associated with recurrent pregnancy loss in the first and second trimester. Relevant congenital Mullerian tract anomalies include unicornuate, didelphys, bicornuate and septate uteri. Pregnancy loss has also been associated with acquired uterine abnormalities that distort the uterine cavity such as intrauterine adhesions and submucosal myomas. Initial evaluation of women with recurrent pregnancy loss should include a uterine assessment such as a pelvic ultrasound or sonohysterography. Uterine abnormalities such as uterine septum, intrauterine adhesions and submucosal myomas may be managed surgically with operative hysteroscopy.
Uterine abnormalities, both congenital and acquired, can be responsible for recurrent pregnancy loss.
综述子宫在复发性流产中所起作用的现有认识。
先天性和获得性子宫异常与第一和第二孕期的复发性流产有关。相关的先天性苗勒管畸形包括单角子宫、双子宫、双角子宫和纵隔子宫。流产也与扭曲子宫腔的获得性子宫异常有关,如宫腔粘连和黏膜下肌瘤。复发性流产女性的初始评估应包括子宫评估,如盆腔超声或超声子宫造影。子宫异常,如子宫中隔、宫腔粘连和黏膜下肌瘤,可以通过宫腔镜手术进行治疗。
先天性和获得性子宫异常均可导致复发性流产。