Wang Si, Hu Qing, Liao Hua, Yu Haiyan
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu, 610041, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Arch Gynecol Obstet. 2025 Mar 21. doi: 10.1007/s00404-025-08001-x.
A unicornuate uterus is a type of Müllerian anomaly and is associated with adverse pregnancy outcomes. However, the perinatal outcomes of twin pregnancies in women with a unicornuate uterus remain unknown, and previous studies on women with a unicornuate uterus have focused mostly on those with singleton pregnancies. This research aimed to investigate the perinatal outcomes of twin pregnancies in women with a unicornuate uterus.
From January 2013 to December 2022, 283 women with a unicornuate uterus, including 21 with twin pregnancies (Group A), 262 with singleton pregnancies (Group B), and 105 with twin pregnancies and a normal uterus (Group C) were enrolled in this study and gave birth at West China Second University Hospital, Sichuan University. General characteristics and perinatal outcomes were retrospectively analysed using SPSS version 22.0.
Among the 21 women with twin pregnancies and a unicornuate uterus, 20 (95.2%) had dichorionic diamniotic twins, and 1 (4.8%) had monochorionic diamniotic twins. Seventeen patients (81.0%) conceived by in vitro fertilization-embryo transfer (IVF-ET), and 4 patients (19.0%) conceived naturally. The mean gestational age at delivery was 33.8 ± 5.7 weeks, and 19 patients (90.5%) underwent caesarean section. The twin group (A) had significantly higher rates of preterm premature rupture of membranes (38.1%, 8/21), preterm delivery (85.7%, 18/21) (preterm delivery was defined as a birth occurring after 28 weeks and before 37 completed weeks of gestation), and neonatal intensive care unit (64.3%, 27/42) admission than Groups B and C (p < 0.05). Moreover, the live birth weight in Group A (1931.7 ± 535.2 g) was lower than that in Groups B and C (p < 0.001).
The incidence of complications and the risk of adverse perinatal outcomes in women with twin pregnancies and a unicornuate uterus are greater than those in women with singleton pregnancies and a unicornuate uterus and women with twin pregnancies and a normal uterus. Thus, maternal and foetal monitoring during pregnancy should be strengthened to achieve good outcomes.
单角子宫是苗勒管异常的一种类型，与不良妊娠结局相关。然而，单角子宫女性双胎妊娠的围产期结局尚不清楚，既往关于单角子宫女性的研究大多集中在单胎妊娠者。本研究旨在调查单角子宫女性双胎妊娠的围产期结局。
2013年1月至2022年12月，本研究纳入了283名单角子宫女性，其中包括21名双胎妊娠者（A组）、262名单胎妊娠者（B组）和105名双胎妊娠且子宫正常者（C组），她们均在四川大学华西第二医院分娩。使用SPSS 22.0软件对一般特征和围产期结局进行回顾性分析。
在21名单角子宫双胎妊娠女性中，20名（95.2%）为双绒毛膜双羊膜囊双胎，1名（4.8%）为单绒毛膜双羊膜囊双胎。17例患者（81.0%）通过体外受精-胚胎移植（IVF-ET）受孕，4例患者（19.0%）自然受孕。平均分娩孕周为33.8±5.7周，19例患者（90.5%）接受了剖宫产。双胎组（A组）胎膜早破早产（38.1%，8/21）、早产（85.7%，18/21）（早产定义为妊娠28周后至37足周前分娩）及新生儿重症监护病房收治率（64.3%，27/42）显著高于B组和C组（p<0.05）。此外，A组的活产儿体重（1931.7±535.2g）低于B组和C组（p<0.001）。
单角子宫双胎妊娠女性的并发症发生率及不良围产期结局风险高于单角子宫单胎妊娠女性及子宫正常的双胎妊娠女性。因此，孕期应加强母胎监测以获得良好结局。
