Department of Obstetrics and Gynecology and Reproductive Medicine, Hopital Foch, Faculté de Médecine Paris Ouest, Suresnes, France.
Department of Obstetrics and Gynecology and Reproductive Medicine, Hopital Foch, Faculté de Médecine Paris Ouest, Suresnes, France.
Fertil Steril. 2021 Mar;115(3):538-545. doi: 10.1016/j.fertnstert.2020.12.003.
Congenital and acquired uterine anomalies are associated with recurrent pregnancy loss (RPL). Relevant congenital Müllerian tract anomalies include unicornuate, bicornuate septate, and arcuate uterus. Recurrent pregnancy loss has also been associated with acquired uterine abnormalities that distort the uterine cavity such as, notably, intrauterine adhesions, polyps, and submucosal myomas. Initial evaluation of women with RPLs should include an assessment of the uterine anatomy. Even if proof of efficacy of surgical management of certain uterine anomalies is often lacking for managing RPLs, surgery should be encouraged in certain circumstances for improving subsequent pregnancy outcome. Uterine anomalies such as uterine septa, endometrial polyps, intrauterine adhesions, and submucosal myomas are the primary surgical indications for managing RPLs.
先天性和获得性子宫异常与复发性妊娠丢失 (RPL) 有关。相关的先天性 Müllerian 管异常包括单角子宫、双角子宫和弓形子宫。复发性妊娠丢失也与扭曲子宫腔的获得性子宫异常有关，如明显的宫腔粘连、息肉和黏膜下肌瘤。对 RPL 患者的初始评估应包括对子宫解剖结构的评估。尽管手术治疗某些子宫异常对治疗 RPL 的疗效证据往往缺乏，但在某些情况下，手术仍应鼓励，以改善后续妊娠结局。子宫纵隔、子宫内膜息肉、宫腔粘连和黏膜下肌瘤等子宫异常是治疗 RPL 的主要手术适应证。
