Heinonen P K
Department of Obstetrics and Gynecology, Tampere University Hospital, Finland.
Fertil Steril. 1997 Aug;68(2):224-30. doi: 10.1016/s0015-0282(97)81506-3.
To evaluate clinical implications of the unicornuate uterus and rudimentary horn.
A retrospective study.
A university hospital.
PATIENT(S): Forty-two women who had a unicornuate uterus with or without rudimentary horn.
INTERVENTION(S): The rudimentary horn was removed in 21 cases.
MAIN OUTCOME MEASURE(S): Presence of other anomalies, fertility, and outcome of pregnancies were studied.
RESULT(S): A right unicornuate uterus with noncommunicating rudimentary horn was the most common type of uterine anomaly. Unilateral renal agenesis was found in 13 (38%) of 34 cases. Six (14%) of the 42 patients had primary infertility. Thirty-four women produced 93 pregnancies; ectopic pregnancy (EP; rudimentary horn, tubal) occurred in 20 of these cases (22%). The pregnant uterine horn ruptured in 3 of 7 cases. Eight (57%) of the 14 women with infertility underwent treatment by IVF-ET; 4 of them conceived, and 2 had term delivery. The fetal survival rate was 61%, prematurity 17%, fetal growth retardation 5%, and the spontaneous intrauterine (IU) abortion rate was 16%. Pregnancy-induced hypertension (PIH) was more common in women lacking a kidney than in those with two kidneys.
CONCLUSION(S): The high number of EPs indicates removal of rudimentary horn and its tube when diagnosed. The prognosis of IU pregnancy is not impaired in the unicornuate uterus although prematurity threatens. Unilateral renal agenesis is associated with PIH.
评估单角子宫及残角子宫的临床意义。
一项回顾性研究。
一所大学医院。
42名单角子宫伴或不伴残角子宫的女性。
21例患者切除了残角子宫。
研究其他异常情况的存在、生育能力及妊娠结局。
右侧单角子宫伴非交通性残角子宫是最常见的子宫异常类型。34例患者中有13例（38%）发现单侧肾缺如。42例患者中有6例（14%）原发性不孕。34名女性有93次妊娠；其中20例（22%）发生异位妊娠（残角子宫妊娠、输卵管妊娠）。7例中有3例妊娠子宫角破裂。14例不孕女性中有8例（57%）接受了体外受精-胚胎移植治疗；其中4例受孕，2例足月分娩。胎儿存活率为61%，早产率为17%，胎儿生长受限率为5%，自然宫内流产率为16%。无肾女性妊娠高血压综合征（PIH）比有双肾女性更常见。
异位妊娠发生率高表明诊断时应切除残角子宫及其输卵管。单角子宫宫内妊娠的预后虽受早产威胁但未受损害。单侧肾缺如与妊娠高血压综合征有关。
