宫内节育器含左炔诺孕酮且妊娠后才被发现的女婴先天性男性化。

Congenital virilization of female infants recognized after pregnancies with retained levonorgestrel intrauterine devices.

作者信息

Hougen Helen Y, Seideman Casey A, Adam Margaret P, Amies Oelschlager Anne-Marie, Fechner Patricia Y, Ramsell Linda, Shnorhavorian Margarett, Squire Audrey, Austin J Christopher

机构信息

Department of Urology, Oregon Health and Sciences University, 3303 SW Bond Ave. CH10U. Portland, OR, 97239, USA.

Division of Pediatric Urology, Department of Urology, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Rd. Portland, OR, 97239, USA.

出版信息

J Pediatr Urol. 2020 Apr;16(2):241-243. doi: 10.1016/j.jpurol.2020.03.008. Epub 2020 Mar 20.

DOI:10.1016/j.jpurol.2020.03.008

PMID:32265103

Abstract

The Mirena intrauterine device (IUD) is a hormone-secreting contraceptive device. Pregnancy with the Mirena is rare and effects to the fetus are unknown. Here we present four females with genital virilization after pregnancy with persistent Mirena IUD. All patients had a 46, XX karyotype and normal hormone evaluation. All underwent exam under anesthesia, demonstrating posterior labial fusion and short urogenital sinus with normal bladder, urethra, vagina, and cervix. Three of four patients underwent flap vaginoplasty without complications and good cosmetic outcomes. This series suggests that persistent levonorgestrel-secreting IUD during pregnancy is associated with genital virilization in female fetuses.

摘要

曼月乐宫内节育器（IUD）是一种分泌激素的避孕装置。带曼月乐怀孕很罕见，其对胎儿的影响尚不清楚。在此，我们报告4例怀孕后带有曼月乐宫内节育器并出现生殖器男性化的女性病例。所有患者核型均为46, XX，激素评估正常。所有患者均在麻醉下接受检查，结果显示阴唇后联合融合，泌尿生殖窦短，膀胱、尿道、阴道和宫颈正常。4例患者中有3例行皮瓣阴道成形术，无并发症，美容效果良好。该系列病例表明，孕期持续使用释放左炔诺孕酮的宫内节育器与女性胎儿生殖器男性化有关。