纵隔子宫的诊断

Diagnosis of septate uterus

在不同类型的结构性子宫畸形中,纵隔子宫最为常见,且与不良妊娠结局有关。纵隔子宫是胚胎在第20周之前连接双侧副中肾管的组织融合失败所致。许多纵隔子宫患者并无症状,因此很难确定其真实发生率。纵隔子宫常在不孕症评估中被诊断出,通过损害生育能力及增加不良妊娠结局影响生殖健康。子宫和宫颈/阴道的异常发育统称为苗勒管发育异常。目前尚无统一的诊断苗勒管发育异常的金标准。苗勒管发育异常的常规首选诊断方法是二维超声,结合三维超声、磁共振成像、子宫输卵管超声造影、子宫输卵管造影、宫腔镜检查和腹腔镜检查等方法可提高准确度。

The septate uterus is the most common structural uterine anomalies and it is associated with the poor reproductive outcome.It is believed to be the result of the failure in resorption of the tissue connecting the 2 paramesonephric ducts prior to the 20th embryonic week.The true prevalence of uterine septum is difficult to ascertain,as many uterine septal defects are asymptomatic.The septate uterus is usually diagnosed during an infertility evaluation and affects reproductive health by impairing fertility and increasing adverse pregnancy outcomes.The variations in uterine and cervical/vaginal anomalies collectively referred to as Müllerian anomalies.No consistent gold standard for the diagnosis of Müllerian anomalies exists.The preferred diagnostic method for Müllerian anomalies is two-dimensional ultrasound,other methods such as three-dimensional ultrasound,magnetic resonance imaging,hysterosalpingo contrast sonography,hysterosalpingography,hysteroscopy,and laparoscopy are also used to improve accuracy.