Brun J L, Lemoine P
Clinique Gynécologique, Hôpital Saint-André, Bordeaux.
Presse Med. 1995 Nov 18;24(35):1658-62.
Malformations of the uterus result from a variety of anomalies during embryogenesis from the 6th to the 17th week of development. Agenesia (not discussed here) should be distinguished from unicornis, pseudo-unicornis, bicornis, bipartitus and communicating uteri (Musset's classification). Such malformations occur in 3 to 4% of all women. Sonography provides the most useful information for diagnosis and should be used as first intention examination together with a work-up to determine extension. In certain cases, hysterography and laparoscopy may be required. Sterility is not increased in women with a malformation of the uterus, but fecundity is reduced due to a high rate of spontaneous abortions (30 to 40%) and premature births (15 to 45%). Obstetrical prognosis in case of a partitioned uterus can be improved by hysteroscopic resection of the partition. Most authors propose endoscopic treatment when a malformation of the uterus is diagnosed during a sterility work-up.
子宫畸形是由发育第6至17周胚胎形成过程中的各种异常所致。子宫发育不全（此处不作讨论）应与单角子宫、假单角子宫、双角子宫、双子宫及相通子宫（穆塞分类法）相鉴别。此类畸形在所有女性中发生率为3%至4%。超声检查为诊断提供了最有用的信息，应作为首选检查方法，并结合进一步检查以确定病变范围。在某些情况下，可能需要进行子宫输卵管造影和腹腔镜检查。子宫畸形女性的不孕率并未增加，但由于自然流产率较高（30%至40%）和早产率较高（15%至45%），生育能力会降低。对于纵隔子宫患者，通过宫腔镜切除纵隔可改善产科预后。大多数作者建议，在不孕症检查过程中诊断出子宫畸形时，应采用内镜治疗。
