New Outpatient Subclassification System for American Fertility Society Classes V and VI Uterine Anomalies
New Outpatient Subclassification System for American Fertility Society Classes V and VI Uterine Anomalies
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DOI：
10.1016/j.jmig.2009.06.002
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发表时间：
2009-09-01
影响因子：
4.1
通讯作者：
Nappi, Carmine
中科院分区：
文献类型：
--
作者：
Gubbini, Giampietro;Sardo, Attilio Di Spiezio;Nappi, Carmine
研究目的：为之前被美国生育学会分类为V类和VI类的子宫异常制定并验证一个简单、系统和可重复的子分类系统，以精确定义每种子宫异常，确认手术矫正异常的可行性和安全性，确定宫腔镜治疗的类型，并提供患者选择、治疗、研究设计：描述性研究（加拿大工作组分类III）。单位：一家私人诊所的妇产科患者：89名患者接受门诊宫腔镜检查，以评估部分或完整的“双”子宫腔。所有患者均行三维超声检查。从宫腔镜和超声检查的数据相结合，产生一个几何模型，包括子宫中隔长度（Z变量）和眼底深度（Y变量），通过一个新的子分类的子宫abnormals.Measurement和主要结果：一个病人在超声检测到双角子宫被排除在研究之外。其余88例患者根据我们的子分类系统进行分类。73例患者被归类为Z 2 cm或更大（隔膜与子宫腔的三分之一或更多相交）和Y大于0 cm（正常或直的子宫底），接受了电切镜子宫成形术，而没有腹腔镜控制。12例患者分类为A1（正常子宫底和隔膜
Study Objective: To produce and validate a simple, systematic and reproducible subclassification system for uterine anomalies previously classified by the American Ferility Society as Class V and VI to achieve a precise definition of each uterine anomaly, confirm the feasibility and safety of surgical correction of the anomalies, determine the type of hysteroscopic treatment, and provide a standard by which patient selection, treatment, and reproductive outcomes can be compared between centers.Design: Descriptive study (Canadian Task Force Classification III).Setting: Department of obstetrics and gynecology of a private clinic (hospital).Patients: Eighty-nine patients undergoing office hysteroscopy to assess partial or complete "double" uterine cavity.Interventions: All patients underwent 3-dimensional ultrasound. Data from hysteroscopy and untrasonography were combined to produce a geometric model comprising uterine septum length (Z variable) and fundus depth (Y variable) through which a new subclassification of the uterine anomalies was elaborated.Measurement and Main Results: One patient with a bicornuate uterus detected at ultrasonography was excluded from the study. The remaining 88 patients were classified according to our subclassification system. Seventy-three patients categorized as having Z 2 cm or greater (septum intersecting one-third of the uterine cavity or more) and Y more than 0 cm (normal or straight uterine fundus) underwent resectoscopic metroplasty without laparoscopic control. Twelve patients categorized as A1 (normal uterine fundus and septum