The Prevalence of Mullerian Anomalies in Women with a Diagnosed Renal Anomaly
The Prevalence of Mullerian Anomalies in Women with a Diagnosed Renal Anomaly
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DOI：
10.1016/j.jpag.2020.11.015
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发表时间：
2021-03-23
影响因子：
1.8
通讯作者：
Dietrich, Jennifer E.
中科院分区：
文献类型：
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作者：
O'Brien, Katherine L. O'Flynn;Bhatia, Vinaya;Dietrich, Jennifer E.
研究目的：描述肾异常（RAs.Design，Setting，Participants，Interventions，and Main Outcome Measures）患者中苗勒管异常（MA）的患病率：对2007年至2019年期间在学术儿科医院就诊的RA女性患者进行回顾性图表审查。使用国际疾病分类第9版和第10版代码识别患者。收集的数据包括RA的类型、MA的存在和类型、诊断方法和相关异常。RA亚型分析进行了。结果：我们确定了5590例RA的2007年至2019年。进行随机、回顾性病历审查，研究人群为363例RA患者。总体RA人群中任何MA的患病率为104/363（29%）（95%置信区间，24% - 33%）。肾发育不全患者MA的患病率为59/182（32%），而肾发育不全患者MA的患病率为45/181（25%）。最常见的MA是苗勒管融合失败。只有73/352（21%）的患者在RA诊断时接受了MA筛查。没有诊断为MA的患者187/259（72%）是未经筛选的，要么尚未月经或月经状态不明。结论：所有RA患者中，29%（n = 104/363）有潜在的MA。肾发育不全与发育不全患者MA的患病率无差异。注意到的局限性是，一些患者可能处于苗勒结构评估不理想的年龄，或者可能没有接受过筛查。这些结果表明，需要进行一项前瞻性研究，以确定在诊断为任何RA的患者中筛查MA的循证指南，以避免未被识别的MA引起的并发症。
Study Objective: To characterize the prevalence of Mullerian anomalies (MAs) among patients with renal anomalies (RAs).Design, Setting, Participants, Interventions, and Main Outcome Measures: A retrospective chart review of female patients with RAs who presented to an academic pediatric hospital between 2007 and 2019 was performed. Patients were identified using International Classification of Diseases 9th and 10th revision codes. Data collected included the type of RA, presence and type of MA, method of diagnosis, and associated anomalies. RA subtype analysis was performed.Results: We identified 5590 cases of RA for the years 2007 through 2019. A random, retrospective chart review was performed resulting in a study population of 363 RA patients. The prevalence of any MA in the overall RA population was 104/363 (29%) (95% confidence interval, 24% - 33%). The prevalence of MA for patients with renal agenesis was 59/182 (32%) compared with 45/181 (25%) for patients with renal dysgenesis. The most common MA were failures of Mullerian duct fusion. Only 73/352 (21%) of patients received screening for a MA at the time of RA diagnosis. Of patients without a diagnosed MA 187/259 (72%) were unscreened and either not yet menarchal or had unknown menarchal status.Conclusions: Of all RA patients, 29% (n = 104/363) had an underlying MA. No difference was found in the prevalence of MA in patients with renal agenesis vs dysgenesis. Limitations noted are that some patients might be of an age at which assessment of the Mullerian structures is suboptimal or who might not have been screened. These results suggest the need for a prospective study to determine evidence-based guidelines for screening for MA among patients diagnosed with any RA to avoid complications from an unrecognized MA.