女性生殖道畸形新分类

New classifications for female genital tract malformations

女性生殖道畸形是涉及子宫、宫颈、阴道、输卵管极其广泛的一大类先天性结构异常,且常合并生殖道以外的器官畸形。由于苗勒管(副中肾管)发育与午非管(中肾管)以及泌尿系发育在胚胎早期密切相关,其中以肾脏畸形最为常见。对不同生殖道畸形的分类目前主要取决于结构特征和临床表现,也力求与胚胎发育学相联系,最具代表性的分类法包括美国生育协会(AFS)分类法(1988)、阴道-宫颈-子宫-附件-相关畸形(VCUAM)分类法(2005)和欧洲人类生殖与胚胎学会和欧洲妇科内镜协会(ESHRE/ESGE)的女性生殖道先天异常分类法(2013)。文章将对各自的特点、优点以及局限性进行综述和评论。

Female genital tract malformations are a large group of congenital structural abnormalities that involve the uterus,cervix,vagina and fallopian tubes,and are often combined with organs other than the reproductive tract.Due to the close relationship between embryonic development of Mullerian duct and mesonephric or Wolffian duct as well as the urinary system,renal malformations are the most common malformations.Classification of different malformations at present mainly depends on the structure characteristics and clinical manifestations,considering the embryonic basis at the same time.The most representative classifications include the American Fertility Society（AFS）classification（1988）,VCUAM classification（2005）and the European Society of Human Reproduction and Embryology and European Association for Gynecological Endoscopy（ESHRE/ESGE）classification（2013）.This paper is to review and comment the characteristics,advantages and limitations of each classification system.