目的:探讨宫腔镜下经宫颈切开子宫纵隔时接受或未接受宫颈纵隔切开的子宫纵隔和重复宫颈的妇女的生育结局。
方法:医院伦理委员会批准的回顾性研究。
方法:复旦大学附属妇产科医院,上海,中国。
方法:2008年1月至2020年12月在复旦大学附属妇产科医院行宫腔镜下子宫中隔切口的子宫完全纵隔和重复宫颈的妇女(n=105)。
方法:宫腔镜下隔膜切口。
结果:纳入患者根据是否行颈隔切口进行分组。生殖结果包括妊娠,流产率,早产率,足月出生率,胎膜早破(PROM),并评估宫颈功能不全。无切口组,流产率(7.4%)明显低于切口组(27.6%,p=0.01);早产率(4.6%)明显低于切口组(36.8%);足月分娩率(95.5%)超过切口组(63.2%,p<0.01)。切口组妊娠期胎膜早破和宫颈功能不全的发生率较高(15.8%和10.5%,p<0.01和p=0.03)。
结论:在宫腔镜经宫颈切开子宫纵隔手术中保留了宫颈纵隔的完整子宫和重复宫颈的患者中,观察到生殖结局显着改善。
OBJECTIVE: To investigate the reproductive outcomes of women with complete septate uterus and duplicated cervix who either did or did not receive cervical septum incision during hysteroscopic transcervical incision of the uterine septum.
METHODS: Retrospective study approved by the hospital ethics committee.
METHODS: Obstetrics and Gynecology Hospital of Fudan University, Shanghai,
China.
METHODS: Women with complete septate uterus and duplicated cervix who underwent hysteroscopic transcervical incision of the uterine septum in Obstetrics and Gynecology Hospital of Fudan University between January 2008 and December 2020 (n = 105).
METHODS: Hysteroscopic incision of the septum.
RESULTS: Included patients were grouped according to whether or not cervical septum incision was performed. Reproductive outcomes including gravidity, abortion rate, preterm birth rate, full-term birth rate, premature rupture of membranes, and cervical incompetence were assessed. In the no incision group, the abortion rate (7.4%) was significantly lower than that of the incision group (27.6%, p = .01); the preterm birth rate (4.6%) was significantly lower than that of the incision group (36.8%); and the full-term birth rate (95.5%) exceeded that of the incision group (63.2%, p <.01). Incidence of premature rupture of membranes and cervical incompetence during pregnancy was higher in the incision group (15.8% and 10.5%, p <.01 and p = .03).
CONCLUSIONS: Significantly improved reproductive outcomes were observed among patients with complete septate uterus and duplicated cervix whose cervical septum was preserved during the hysteroscopic transcervical incision of the uterine septum procedure.