Department of Pediatric and Adolescent Gynecology, Children's Minnesota, Minneapolis, MN.
Division of Pediatric Urology, Baylor College of Medicine, Houston, TX.
J Pediatr Adolesc Gynecol. 2021 Apr;34(2):154-160. doi: 10.1016/j.jpag.2020.11.015. Epub 2020 Nov 23.
To characterize the prevalence of Müllerian anomalies (MAs) among patients with renal anomalies (RAs). DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A retrospective chart review of female patients with RAs who presented to an academic pediatric hospital between 2007 and 2019 was performed. Patients were identified using International Classification of Diseases 9th and 10th revision codes. Data collected included the type of RA, presence and type of MA, method of diagnosis, and associated anomalies. RA subtype analysis was performed.
We identified 5590 cases of RA for the years 2007 through 2019. A random, retrospective chart review was performed resulting in a study population of 363 RA patients. The prevalence of any MA in the overall RA population was 104/363 (29%) (95% confidence interval, 24% - 33%). The prevalence of MA for patients with renal agenesis was 59/182 (32%) compared with 45/181 (25%) for patients with renal dysgenesis. The most common MA were failures of Müllerian duct fusion. Only 73/352 (21%) of patients received screening for a MA at the time of RA diagnosis. Of patients without a diagnosed MA 187/259 (72%) were unscreened and either not yet menarchal or had unknown menarchal status.
Of all RA patients, 29% (n = 104/363) had an underlying MA. No difference was found in the prevalence of MA in patients with renal agenesis vs dysgenesis. Limitations noted are that some patients might be of an age at which assessment of the Müllerian structures is suboptimal or who might not have been screened. These results suggest the need for a prospective study to determine evidence-based guidelines for screening for MA among patients diagnosed with any RA to avoid complications from an unrecognized MA.
描述患有肾异常（RA）的患者中 Müllerian 异常（MA）的患病率。
设计、地点、参与者、干预措施和主要结果测量：对 2007 年至 2019 年在一家学术儿科医院就诊的患有 RA 的女性患者进行了回顾性图表审查。使用国际疾病分类第 9 版和第 10 版代码识别患者。收集的数据包括 RA 的类型、MA 的存在和类型、诊断方法以及相关异常。进行了 RA 亚型分析。
我们确定了 2007 年至 2019 年期间的 5590 例 RA 病例。进行了随机回顾性图表审查，得出了 363 例 RA 患者的研究人群。在整个 RA 人群中，任何 MA 的患病率为 104/363（29%）（95%置信区间，24%-33%）。在患有肾发育不全的患者中，MA 的患病率为 59/182（32%），而在患有肾发育不全的患者中，MA 的患病率为 45/181（25%）。最常见的 MA 是 Müllerian 管融合失败。在 RA 诊断时，只有 73/352（21%）的患者接受了 MA 筛查。在没有诊断出 MA 的患者中，187/259（72%）未接受筛查，要么尚未初潮，要么初潮情况未知。
在所有 RA 患者中，有 29%（n=104/363）存在潜在的 MA。在患有肾发育不全和发育不全的患者中，MA 的患病率没有差异。需要注意的限制是，一些患者可能处于评估 Müllerian 结构不理想的年龄，或者可能没有接受筛查。这些结果表明需要进行一项前瞻性研究，以确定针对任何 RA 患者筛查 MA 的循证指南，以避免因未识别的 MA 而产生的并发症。
