妊娠合并子宫发育异常125例妊娠结局分析

The Clinical Analysis of Pregnancy Outcome of 125 Cases of Pregnancy Complicated with Uterine Malformations

目的:探讨不同类型先天性子宫发育异常妊娠对母婴的影响。方法:选择2002年10月1日至2012年10月1日在中山大学附属第一医院妇产科诊治的先天性子宫发育异常合并妊娠的患者125例为研究组,同期正常子宫妊娠100例为对照组。观察并比较两组间母儿情况,同时比较研究组中各种子宫发育异常类型孕妇的妊娠及诊断情况。结果:1研究组的自然流产率、早产率、剖宫产率、胎位异常率、胎膜早破率及新生儿窒息发生率均明显高于对照组(P<0.05),而足月产率、顺产率和新生儿的平均体重明显低于对照组(P<0.05)。2各种类型子宫发育异常在自然流产率、早产率、剖宫产率、胎位异常率、胎膜早破率及新生儿窒息发生率方面比较,差异均无统计学意义(P>0.05)。3中隔子宫、双子宫、双角子宫产前诊断率较高为68.8%、86.4%、75.0%,单角子宫、残角子宫、鞍状子宫产时诊断率较高为100.0%、85.7%、76.0%。结论:妊娠合并子宫发育异常可以对母儿造成不良影响,各种子宫发育异常的确诊时间存在差异,但对母儿不良影响无明显差异,临床医生应加强孕期及产时的管理。

Objective：To study the effect of congenital uterine malformations on outcomes of mother and fetus of pregnancy. Methods：The clinical data of 125 pregnant women complicated with congenital uterine malformation and 100 pregnant women with normal uterus who delivered in the obstetrics and gynecology of the First Affiliated Hospital of Sun Yat-Sen University from October 1 2002 to October 1 2012 were retrospec- tively analyzed. The condition of mother and fetus and diagnosis time between the two groups were com- pared. Results：①Compared with the control group,the patient group had significantly higher rates in sponta- neous abortion, premature delivery, caesarean section, abnormal fetal position, premature rupture of mem- branes, asphyxia neonatorum （ P 〈 0. 05） and had significantly lower weight in neonatus （ P 〈 0. 05）. ②Of the all types of uterine malformation,there was no difference in the rate of spontaneous abortion, premature deliv- ery,caesarean section,abnormal fetal position,premature rupture of membranes,asphyxia neonatorum（ P〉 0. 05）. ③The rate of seperate uterus, uterus duplex, uterus bicornis diagnosed in the prenatal period was 68. 8% ,86. 4% ,75. 0%, respectively;the rate of uterus unicomis, rudimentary horn of uterus, saddle form u- terus diagnosed in the intrapartum periods was 100.0%, 85.7%, 76.0%, respectively. Conclusions. Con- genital uterine malformation diagnosed in pregnancy has a negative effect on women and fetus, the time con- firmed of the all types of uterine malformation is different, but adverse effects on women and fetus has no ob- vious differences in all types of the uterine malformation, the clinician should enhance the care of these patients in the antenatal and intrapartum management.