妊娠期先天性子宫异常会增加流产等妊娠并发症的风险,早产,胎儿畸形,剖宫产,胎儿生长受限.然而,除了上述以外,很少有研究检查子宫异常与围产期并发症的关系。我们调查了由先天性子宫异常并发的妊娠与我们机构的各种围产期结局之间的关联。
■这项回顾性队列研究于2009年1月至2021年5月进行。我们纳入了子宫异常的病例,如隔膜,bicornuate,独角兽,和双形子宫。首先,比较了合并子宫异常的妊娠和子宫正常的妊娠的围产期并发症和新生儿结局.第二,我们根据子宫异常的类型进行了分析,分为两组:轻微异常组由限于子宫腔的异常组成,比如纵隔子宫,而主要异常组包括影响子宫形状的异常,比如双角,独角兽,和双形子宫。我们比较了主要异常中围产期并发症的发生率,轻微异常,和正常子宫组。
■在研究期间,45例妊娠合并子宫异常。轻微异常组包括11例患者,主要异常组包括34例患者。子宫异常组的胎儿畸形发生率明显高于正常子宫组(18%vs.3.7%,p=.04)。此外,在子宫异常组中,胎盘索插入异常的频率显着升高(16%vs.3.7%,p=.01)。根据子宫异常类型进行的检查显示宫颈功能不全存在显着差异,陈述不当,剖宫产,胎盘索插入异常。有轻微异常的患者更容易出现宫颈功能不全。相比之下,胎儿畸形,剖宫产,在主要异常组中,胎盘索插入异常的可能性更大。
■除了先前研究报告的发现之外,在妊娠合并子宫异常的情况下,胎盘索插入异常更为常见。
UNASSIGNED: Congenital uterine anomalies during pregnancy increase the risk of pregnancy complications such as miscarriage, preterm delivery, fetal malpresentation, cesarean delivery, and fetal growth restriction. However, few studies have examined uterine anomalies in relation to perinatal complications other than those mentioned above. We investigated the association between pregnancies complicated by congenital uterine anomalies and various perinatal outcomes at our institution.
UNASSIGNED: This retrospective cohort study was conducted from January 2009 to May 2021. We included cases of uterine anomalies, such as septate, bicornuate, unicornuate, and didelphic uterus. First, the perinatal complications and neonatal outcomes were compared between pregnancies complicated by uterine anomalies and those with normal uteri. Second, we conducted an analysis based on the type of uterine anomalies classified into two groups: the minor anomaly group consisted of anomalies limited to the uterine cavity, such as the septate uterus, whereas the major anomaly group included anomalies affecting the uterine shape, such as bicornuate, unicornuate, and didelphic uterus. We compared the incidence of perinatal complications among the major anomaly, minor anomaly, and normal uterus groups.
UNASSIGNED: During the study period, 45 pregnancies were complicated with uterine anomalies. The minor anomaly group included 11 patients and the major anomaly group included 34 patients. The incidence of fetal malpresentation was significantly higher in the uterine anomaly group than in the normal uterus group (18% vs. 3.7%, p = .04). Furthermore, the frequency of abnormal placental cord insertion was significantly higher in the uterine anomaly group (16% vs. 3.7%, p = .01). Examination based on the type of uterine anomaly revealed significant differences in cervical incompetence, malpresentation, cesarean section, and abnormal placental cord insertion. Cervical incompetence was more likely in patients with minor anomalies. In contrast, fetal malpresentation, cesarean section, and abnormal placental cord insertion were more likely in the major anomaly group.
UNASSIGNED: In addition to the findings reported in previous studies, abnormal placental cord insertion was more frequent in pregnancies complicated by uterine anomalies.