摘要目的 探讨子宫发育异常的发病情况、临床特征、诊治方法及其对生育的影响.方法 选取1990年3月-2005年1月北京大学人民医院收治的子宫发育异常患者225例的临床资料,进行回顾性分析,总结不同类型子宫发育异常的构成比、临床特征、诊治方法及对生育的影响.结果 (1)225例子宫发育异常患者中,中隔子宫125例,占55.6%,其中122例(97.6%,122/125)患者妊娠,但影响其妊娠结局,出现流产、胎位异常、早产、前置胎盘、胎膜早破等并发症.(2)双子宫51例,占22.7%(51/225);其中50例(98%,50/51)患者妊娠,对妊娠无明显影响;5例(10%,5/51)合并泌尿系统畸形.(3)残角子宫26例(11.6%,26/225),发生残角子宫妊娠4例(15%,4/26),残角子宫同侧输卵管妊娠1例(4%,1/26);2例(8%,2/26)合并泌尿系统畸形;合并不孕4例(15%,4/26).(4)双角子宫14例,占6.2%(14/225),无不孕患者,出现早产、胎膜早破等并发症;1例(7%,1/14)合并泌尿系统畸形.(5)其他类型:鞍状子宫4例(1.8%,4/225),无不孕患者;无子宫3例(1.3%,3/225),均以原发闭经就诊;单角子宫2例(0.9%,2/225),均合并不孕.结论 子宫发育异常中以中隔子宫最多见.中隔子宫、双子宫、双角子官、残角子宫、鞍状子宫对生育无明显影响,但在妊娠期可出现不同的并发症.子宫发育异常常合并泌尿系统畸形.无症状的子宫发育异常,可不予处理.

abstractsObjective To investigate the prevalence, clinical features, diagnosis, treatment and the influence on procreation of uterine malformation. Methods Totally 225 women with uterine malformation referred to our hospital from Mar 1990 to Jan 2005 were involved in this retrospective analysis.The constituent ratio, clinical feature, diagnosis, treatment and the influence on procreation were analyzed.Results (1) Among 225 cases of uterine malformation, 125 cases (55.6%) were septate uterus; 122(97.6%, 122/125 ) of these patients became pregnant, but always associated with a high risk of reproductive failure and obstetrical complications, such as abortion, abnormal fetal presentation, premature rupture of membrane. (2) Among 51 cases (22. 2%, 51/225 ) of didelphia, 50 cases (98%, 50/51 )became pregnant without any influence from this malformation. Five cases were combined with urinary system complication. (3) Among 26 cases (9.7%, 26/225 ) of rudimentary horn of uterus, 4 cases (15%, 4/26)became pregnant, and 1 case (4%, 1/26) presented with ipsilateral oviduct ectopic pregnancy; 2 cases (8%, 2/26) were combined with urinary deformities. (4) In 14 cases (6. 2%, 14/225) of bicornuate uterus, 1 case (7%, 1/14) presented with urinary tract abnormalities; gestations were more common, but due to the uterine structural abnormality, recurrent miscarriage and premature delivery were unavoidable.(5) Others: none came up with sterility in 4 cases (1. 8%, 4/225) of saddle shaped uterus. All the three cases ( 1.3% , 3/225) of ametria were with the chief complaint of primary amenorrhea. Two cases of unicornis uterus (0.9%, 2/225) were both complicated with sterility, while neither with urinary system deformities. Conclusions Among uterine malformations, septate uterine is the most common type. Septate uterus, didelphic uterus, bicornuate and rudimentary horn of uterus do not affect pregnancy, but can cause different complications. Unicornis uterus always causes sterility. Uterus malformations often come up with urinary system deformities.