Zou Y Q, Chen X X, Feng Y
Zhonghua Fu Chan Ke Za Zhi. 2020 Aug 25;55(8):510-515. doi: 10.3760/cma.j.cn112141-20200107-00019.
To analyze the perinatal outcomes of unicornuate uterus pregnancy. The clinical data of patients with unicornuate uterus pregnancy who delivered between January 2009 and December 2018 in Women's Hospital, School of Medicine, Zhejiang University, were reviewed retrospectively. Live birth was defined as the delivery of a baby after at least 28 weeks gestational age. Ninety-eight patients were diagnosed as unicornuate uterus, while 4 cases of stillbirth and 4 cases of twin pregnancy and 10 cases of incomplete data were excluded, and 80 patients with unicornuate uterus were included in the observation group. By matching the age, gestational age and delivery mode, 160 patients were randomly selected as the control group. The perinatal outcomes such as delivery mode, cesarean section indication sequence, postpartum hemorrhage, vaginal delivery time, newborn birth weight and Apgar score were analyzed retrospectively. In the unicornuate uterus group, there were 10 cases of vaginal delivery and 70 cases of cesarean section, among which the primary indication of premature cesarean section and full-term cesarean section was abnormal fetal position, accounting for 7/18 and 50.0% (26/52), respectively. While in the control group, there were 20 cases of vagianl delivery and 140 cases of cesarean section, among which the main indications of premature cesarean section were placenta previa, intrahepatic cholestasis during pregnancy and scar uterus, accounting for 19.4% (7/36), and the primary indication of full-term cesarean section was abnormal fetal position, accounting for 23.1% (24/104). The postpartum hemorrhage of the vaginal delivery in the unicornuate uterus group and the control group was (319±161) and (261±152) ml, respectively, and the postpartum hemorrhage of the cesarean section delivery was (257±106) and (272±123) ml, respectively. There were no significant differences between the two groups statistically (all >0.05). The time of the first stage of labor was (502±386) and (465±296) minutes in the unicornuate uterus group and the control group, and the time of the second stage was (74±73) and (47±30) minutes, respectively. There were no significant differences between the two groups statistically (all >0.05). The neonatal birth weight in the unicornuate uterus group and the control group was (3 018±548) and (3 080±562) g, respectively, and there was no significant difference between the two groups statistically (=0.42). According to preterm birth and different pre-pregnancy body mass index, the neonatal birth weight of the two groups were compared, and the differences were not statistically significant (all >0.05). One-minute Apgar score of premature in the unicornuate uterus group and the control group were 10 (9.25-10) and 10 (10-10), 5-minute Apgar score were 10 (10-10) and 10 (10-10), respectively. One-minute Apgar score of full-term in the unicornuate uterus group and the control group were 10 (10-10) and 10 (10-10), 5-minute Apgar score were 10 (10-10) and 10 (10-10), respectively. There were no statistically significant differences between the two groups, respectively (all >0.05). The patients with unicornuate uterus could give birth vaginally in the absence of other operation indications. The perinatal outcome of women with unicornuate uterus is similar to that of women with non-uterine abnormalities. It is found that the abnormal fetal position with unicornuate uterus is the main reason for cesarean section.
分析单角子宫妊娠的围产期结局。回顾性分析2009年1月至2018年12月在浙江大学医学院附属妇产科医院分娩的单角子宫妊娠患者的临床资料。活产定义为孕龄至少28周后分娩婴儿。98例患者被诊断为单角子宫，排除4例死产、4例双胎妊娠及10例资料不全者，80例单角子宫患者纳入观察组。通过匹配年龄、孕周及分娩方式，随机选取160例患者作为对照组。回顾性分析两组的分娩方式、剖宫产指征顺序、产后出血、阴道分娩时间、新生儿出生体重及Apgar评分等围产期结局。单角子宫组阴道分娩10例，剖宫产70例，其中早产剖宫产及足月剖宫产的首要指征均为胎位异常，分别占7/18及50.0%（26/52）。而对照组阴道分娩20例，剖宫产140例，其中早产剖宫产的主要指征为前置胎盘、妊娠期肝内胆汁淤积症及瘢痕子宫，占19.4%（7/36），足月剖宫产的首要指征为胎位异常，占23.1%（24/104）。单角子宫组与对照组阴道分娩后的产后出血量分别为（319±161）ml及（261±152）ml，剖宫产分娩后的产后出血量分别为（257±106）ml及（272±123）ml。两组间差异均无统计学意义（均>0.05）。单角子宫组与对照组第一产程时间分别为（502±386）分钟及（465±296）分钟，第二产程时间分别为（74±73）分钟及（47±30）分钟。两组间差异均无统计学意义（均>0.05）。单角子宫组与对照组新生儿出生体重分别为（3018±548）g及（3080±562）g，两组间差异无统计学意义（=0.42）。根据早产及孕前不同体重指数比较两组新生儿出生体重，差异均无统计学意义（均>0.05）。单角子宫组与对照组早产1分钟Apgar评分分别为10（9.25 - 10）及10（10 - 10），5分钟Apgar评分分别为10（10 - 10）及10（10 - 10）。单角子宫组与对照组足月1分钟Apgar评分分别为10（10 - 10）及10（10 - 10），5分钟Apgar评分分别为10（10 - 10）及10（10 - 10）。两组间差异均无统计学意义（均>0.05）。无其他手术指征时，单角子宫患者可经阴道分娩。单角子宫女性的围产期结局与无子宫异常的女性相似。发现单角子宫胎位异常是剖宫产的主要原因。
