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摘要:
目的 探讨单角子宫妊娠的临床特点及围产期结局。 方法 回顾2007年1月至2016年12月于北京协和医院分娩的单角子宫患者临床资料, 分析其一般特征、诊断方法、妊娠期和分娩期并发症、分娩方式及围产期结局。 结果 本研究共纳入23例单角子宫妊娠患者的24次成功妊娠。患者分娩时年龄(30.96±3.61)岁, 孕前超声诊断4例(17.4%), 早孕期超声诊断3例(13.0%), 子宫输卵管造影诊断6例(26.1%), 既往手术探查诊断7例(30.4%), 本次分娩过程中诊断3例(13.0%)。既往15次妊娠中不良结局9次(60%), 主要为自然流产或胚胎停育, 本次妊娠期间发生脐带绕颈45.84%、臀位29.17%、胎儿生长受限16.67%。24例次分娩孕周(37.55±2.38)周, 剖宫产率95.8%, 产时出血量(177±49)ml, 新生儿全部成活(100%), 体重(2826.0±692.8)g。 结论 单角子宫妊娠胎儿并发症发生率高于普通人群, 但大多可获得良好的妊娠结局。 Abstract:Objective To investigate the clinical characteristics and perinatal outcomes of unicornuate uterus pregnancy. Methods The clinical data of patients with unicornuate uterus pregnancy who delivered between January 2007 and December 2016 in the Peking Union Medical College Hospital were retrospectively reviewed, and the general characteristics, diagnostic methods, complications during gestational and delivery period, mode of delivery and perinatal outcomes were analyzed. Results Twenty-three patients with unicornuate uterus pregnancy (24 successful pregnancies) were included in this study. The age of the patients at delivery was (30.96±3.61) years, 4 cases(17.4%) were diagnosed with ultrasound before pregnancy, 3 cases (13.0%) were diagnosed by ultrasound during the first trimester, 6 cases(26.1%) were diagnosed by hysterosalpingography, 7 cases (30.4%) were diagnosed based on previous surgical exploration, and 3 cases (13%) were diagnosed during the present deliveries. Adverse outcomes were observed in 9 cases(60%) among 15 previous deliveries, including mainly spontaneous abortion or embryo arrest. Adverse outcomes during the present pregnancies included nuchal cord (45.84%), breech position (29.17%), and fetal growth restriction (16.67%). Gestational age at birth was (37.55±2.38) weeks, cesarean section rate was 95.8%, intrapartum bleeding volume was (177±49)mL, neonatal survival rate was 100%, and neonatal body weight was (2826.0±692.8)g. Conclusions The incidence rate of fetal complications in unicornuate uterus pregnancy is higher than that in the general population, but most of them can achieve good pregnancy outcomes. -
Key words:
- unicornuate uterus /
- uterine malformation /
- pregnancy outcome /
- pregnancy complication
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