宫腔镜检查在自然流产中的应用

Application of Hysteroscopy in Spontaneous Abortion

目的:探讨采用宫腔镜检查早期明确自然流产患者宫腔异常因素的必要性。方法:回顾150例有1次及以上自然流产史行宫腔镜检查的患者的临床资料,对宫腔镜检查的结果进行分析,对比1次、2次、3次及以上自然流产患者的宫腔异常发生率,比较原发性RSA和继发性RSA宫腔异常的发生率。结果:150例自然流产患者中,宫腔异常占42.0%(63/150),最常见的先天性和获得性子宫异常分别是中隔子宫16.0%(24/150)和宫腔粘连13.3%(20/150),1次、2次、3次及以上自然流产患者中宫腔异常比例比较差异无统计学意义(P>0.05),继发性RSA和原发性RSA的宫腔异常发生率比较差异无统计学意义(P>0.05)。结论:为了明确导致自然流产发生的宫腔异常因素,有必要对自然流产包括1次偶发自然流产和继发性RSA患者及早进行宫腔镜检查。

Objective： To investigate the necessity of early diagnosing congenital and acquired intrauterine causes of spontaneous abortion by hysteroscopy. Method： The clinical data of 150 patients who underwent hysteroseopy with history of once or more than once abortions were reviewed, the hysteroseopy results were analyzed.The frequency of uterine anomalies diagnosed by hysteroscopy following one, two and three or more abortions was compared.The frequency of uterine anomalies diagnosed by hysteroseopy was compared between the primary RSA and the secondary RSA.Result： In 150 patients with spontaneous abortion, uterine anomalies accounted for 42.0%（63/150）.The uterine septum and uterine adhesion were the highest in congenital or acquired uterine anomalies respectively, the incidence rate were 16.0%（24/150） and 13.3%（20/150） respectively.There was no significant difference in the frequency of uterine anomalies among the patients with abortions for once, twice, and three times or more（P〉0.05）.The occurrence of a prior live birth did not influence the frequency of uterine anomalies between the patients with primary RSA and secondary RSA, there was no statistically significant differenee（P〉0.05）.Condusion： In order to clarify the cause of intrauterine abnormal factors of spontaneous abortion, it is necessary for spontaneous abortion including 1 sporadic spontaneous abortion and secondary RSA patients with early hysteroscopy.