宫腔粘连带和妊娠结局分析

目的妊娠期宫腔粘连带通常被认为是良性现象.通过对1万余例分娩围产儿结局进行分析,检验宫腔粘连带和妊娠不良结局相关的假设.方法对2015年6月至2016年12月期间在本院孕17~26周常规B超筛查的单胎孕妇进行回顾性研究.多胎妊娠、羊膜腔索带和先天性子宫畸形的妊娠被排除在外.对宫腔粘连带组和非宫腔粘连带组孕妇的妊娠结局进行比较.结果有10239例妊娠符合纳入标准,144例(0.14%)诊断为宫腔粘连带.子宫粘连的妇女更易发生因胎位异常剖宫产(13.2%比3.4%),前置胎盘(4.86%比1.34%),未足月胎膜早破(4.86%比1.34%).胎儿生长受限和早产的风险无显著性差异.结论宫腔粘连带与因胎位异常行剖宫产术、前置胎盘和未足月胎膜早破的风险显著增加相关.妊娠合并宫腔粘连带是良性现象的概念应该重新评估.

Objective Uterine synechiae have generally been considered benign findings in pregnancy.To test hypotheses related to intrauterine adhesions and adverse pregnancy outcomes by analysis of perinatal outcomes in more than 10,000 cases of delivery.Methods A retrospective cohort study of women with singleton pregnancies presenting was performed for routine ultrasonographic examinations at 17-26 weeks from June 2015 to December 2016.Pregnancies with multiple fetuses,amniotic bands,and congenital uterine anomalies were excluded.The pregnancy outcomes were compared between women with and without uterine synechiae.Results Of 10239 pregnancies met inclusion criteria,144(0.14%)were diagnosed with uterine synechiae.Women with uterine synechiae were significantly more likely to have cesarean delivery for malpresentation(13.2% compared with 3.4%),placenta previa(4.86% compared with 1.34%),preterm premature rupture of membranes(PROM)(4.86% compared with 2.73%),and The risks of fetal growth restriction and pretemi delivery wfere not significantly different.Conclusion Uterine synechiae are associated with significant increase in the risk of and cesarean delivery for malpresentation,placental previa and preterm PROM.The notion of uterine synechiae as benign findings in pregnancy should be reevaluated.