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下段剖宫产术中诊断出的罕见隐匿性苗勒管畸形

Rare and Occult Müllerian Deformity Diagnosed Intraoperatively During Lower Segment Caesarean Section.

作者信息

Shrivastava Prakher, Shrivastava Deepti, Shrivastava Priyal, Rawlani Shobha, Chimurkar Vilas

机构信息

Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2023 Oct 11;15(10):e46861. doi: 10.7759/cureus.46861. eCollection 2023 Oct.

DOI:10.7759/cureus.46861
PMID:37954795
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10637768/
Abstract

Uterine anomalies are the rare entities seen due to fusion defects or agenesis of Müllerian ducts in embryonic life. They are usually associated with renal defects. If non-obstructive in nature, they hardly become symptomatic until the beginning of their obstetric carrier, when they present with infertility, recurrent pregnancy loss, preterm pregnancy, rudimentary horn rupture, an ectopic baby, and numerous more negative effects. We are presenting a case report of a patient who was suffering from infertility, attempted IUI treatment five times, then stopped the treatment due to economic affordability issues, conceived spontaneously, and underwent preterm lower segment cesarean section (LSCS) due to fetal distress. During LSCS, it was found to be type 2C of the American Fertility Society (AFS) Müllerian anomaly. The post-operative period was uneventful; both mother and baby were fine, and they were discharged.

摘要

子宫异常是胚胎期苗勒管融合缺陷或发育不全导致的罕见情况。它们通常与肾脏缺陷有关。如果本质上是非梗阻性的,在产科生涯开始之前它们几乎不会出现症状,此时会表现为不孕、复发性流产、早产、残角破裂、宫外孕以及许多其他负面影响。我们报告一例患者,该患者患有不孕症,尝试了5次宫腔内人工授精(IUI)治疗,后因经济承受能力问题停止治疗,自然受孕,并因胎儿窘迫接受了下段剖宫产术(LSCS)。在剖宫产术中,发现其为美国生育协会(AFS)苗勒管异常2C型。术后恢复顺利;母婴均状况良好,随后出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c8d/10637768/f7c6b8471bf0/cureus-0015-00000046861-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c8d/10637768/d0a35c8c88c1/cureus-0015-00000046861-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c8d/10637768/76fa1f545ce6/cureus-0015-00000046861-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c8d/10637768/f7c6b8471bf0/cureus-0015-00000046861-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c8d/10637768/d0a35c8c88c1/cureus-0015-00000046861-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c8d/10637768/76fa1f545ce6/cureus-0015-00000046861-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c8d/10637768/f7c6b8471bf0/cureus-0015-00000046861-i03.jpg

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本文引用的文献

1
Unicornuate Uterus with Noncommunicating Rudimentary Horn (Class U4aC0V0/ESHRE/ESGE Classification) and a Communicating Bladder Endometriotic Nodule.单侧单角子宫合并未交通残角(U4aC0V0/ESHRE/ESGE 分类)及交通性膀胱子宫内膜异位症结节。
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ASRM müllerian anomalies classification 2021.美国生殖医学学会 Müllerian 畸形分类 2021 版
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An unprecedented occult non-communicating rudimentary uterine horn treated with laparoscopic excision and preservation of both fallopian tubes: a case report and review of the literature.
经腹腔镜切除并保留双侧输卵管治疗一例前所未有的隐匿性非交通性残角子宫:病例报告及文献复习。
J Med Case Rep. 2021 Feb 4;15(1):51. doi: 10.1186/s13256-020-02636-x.
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The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review.先天性子宫畸形在非选择性和高危人群中的流行情况:系统评价。
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Incidence of Müllerian defects in fertile and infertile women.
Hum Reprod. 1997 Jul;12(7):1372-6. doi: 10.1093/oxfordjournals.humrep.a019588.