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纵隔子宫的日常诊疗管理:纵隔切开术后的生殖结局

Daily practice management of septate uterus: reproductive outcome after septoplasty.

作者信息

Rousseau L, Brichant G, Timmermans M, Nisolle M, Tebache L

出版信息

Facts Views Vis Obgyn. 2021 Sep;13(3):253-259. doi: 10.52054/FVVO.13.3.032.

Abstract

BACKGROUND

Septate uterus is the most common uterine malformation found in women presenting poor reproductive history. Hysteroscopic septoplasty (HS) restores the uterine anatomy in a safe procedure.

OBJECTIVES

The goal of our study is to determine the reproductive outcomes after HS of symptomatic septate uterus.

MATERIALS AND METHODS

In a retrospective observational single centre study the reproductive outcomes and complications after HS were evaluated in 31 women with symptomatic septate uterus. The patients were separated into two groups according to the symptoms - infertility or recurrent pregnancy loss (RPL).

MAIN OUTCOME MEASURES

were the pregnancy and live birth rate and secondarily the complication rate. Furthermore, the results were analysed depending on the need of assisted reproductive techniques (ART).

RESULTS

The treatment has resulted in an overall pregnancy rate of 71% for both groups. The spontaneous pregnancy rate is 45% and 8 pregnancies resulted from ART (26%). The overall first live birth rate is 51.6%. A decrease has been noticed in the miscarriage rate from 95.24% to 24% (p<0.001) in the overall population.

CONCLUSIONS

In patients with a symptomatic septate uterus hysteroscopic septoplasty is a safe and effective procedure. The favourable results pointing out the benefits of surgery on the reproductive outcomes as well as the relatively simple and safe technique of HS make the intervention attractive.

摘要

背景

纵隔子宫是有不良生育史女性中最常见的子宫畸形。宫腔镜纵隔切除术(HS)以安全的手术方式恢复子宫解剖结构。

目的

我们研究的目的是确定有症状的纵隔子宫行HS术后的生殖结局。

材料与方法

在一项回顾性观察性单中心研究中,对31例有症状的纵隔子宫患者HS术后的生殖结局和并发症进行评估。根据症状将患者分为两组——不孕或复发性流产(RPL)。

主要观察指标

为妊娠率和活产率,其次为并发症发生率。此外,根据辅助生殖技术(ART)的需求分析结果。

结果

两组的总体妊娠率为71%。自然妊娠率为45%,8例妊娠由ART导致(26%)。总体首次活产率为51.6%。总体人群的流产率从95.24%降至24%(p<0.001)。

结论

对于有症状的纵隔子宫患者,宫腔镜纵隔切除术是一种安全有效的手术。良好的结果表明手术对生殖结局有益,以及HS相对简单安全的技术使该干预具有吸引力。

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本文引用的文献

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No need for septum incision: really?无需切开鼻中隔:真的吗?
Facts Views Vis Obgyn. 2020 Oct 8;12(3):153-154.
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The pathophysiology of septate uterus.
BJOG. 2019 Sep;126(10):1200. doi: 10.1111/1471-0528.15832. Epub 2019 Jul 3.
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The Diagnosis and Surgical Approach of Uterine Septa.子宫隔的诊断与手术方法。
J Minim Invasive Gynecol. 2018 Feb;25(2):209-217. doi: 10.1016/j.jmig.2017.07.017. Epub 2017 Jul 26.
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Uterine septum: a guideline.子宫中隔:指南。
Fertil Steril. 2016 Sep 1;106(3):530-40. doi: 10.1016/j.fertnstert.2016.05.014. Epub 2016 May 25.

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