Midline uterine defect size is correlated with miscarriage of euploid embryos in recurrent cases
Midline uterine defect size is correlated with miscarriage of euploid embryos in recurrent cases
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DOI：
10.1016/j.fertnstert.2008.12.097
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发表时间：
2010-04-01
影响因子：
6.7
通讯作者：
Suzuki, Sadao
中科院分区：
文献类型：
--
作者：
Sugiura-Ogasawara, Mayumi;Ozaki, Yasuhiko;Suzuki, Sadao
目的：比较两次或两次以上流产的先天性子宫畸形患者和无先天性子宫畸形患者的妊娠结局。设计：病例对照研究。地点：名古屋市立大学医院。患者：共42例双角子宫或纵隔子宫患者和1528例正常子宫患者。干预措施：无手术。主要结局指标：累积分娩成功率、流产胎儿染色体核型异常率及缺损高度/剩余宫腔长度比值的预测价值结果：1676例患者中，54例（54/1676）先天性子宫畸形占3.2%; 25 42例双角子宫或纵隔子宫患者中，59.5%的患者经检查后首次妊娠成功，而1528例正常子宫患者中有1096例（71.7%）为这种情况。随访期间累积活产率无差异（78.0%和85.5%）。但在有子宫异常和无子宫异常的流产胎儿中，染色体核型异常的发生率分别为15.4%（2/13）和57.5%（1/233），后者明显高于前者。流产组的D/C比也明显大于活产组。结论（S）：先天性子宫畸形对反复流产夫妇的生殖结局有负面影响，并与胚胎核型正常的进一步流产有关。发现D/C比率对复发病例的进一步流产具有预测价值。（Fertil Steril（R）2010;93：1983-8.（C）2010年由美国生殖医学学会。
Objective: To compare subsequent pregnancy outcomes after two or more miscarriages in patients with and without congenital uterine anomalies.Design: Case-control study.Setting: Nagoya City University Hospital.Patient(s): A total of 42 patients with a bicornuate or septate uterus and 1528 with normal uteri.Intervention(s): No surgery.Main Outcome Measure(s): The cumulative success rate for birth, abnormal chromosome karyotype rate in aborted concepti, and the predictive values of the height of the defect/length of the remaining uterine cavity ratio (D/C ratio).Result(s): Of the total of 1676 patients, 54 (3.2%) had congenital uterine anomalies; 25 (59.5%) of the 42 patients with a bicornuate or septate uterus had a successful first pregnancy after examination, while this was the case for 1096 (71.7%) of the 1528 with normal uteri. There was no difference in the cumulative live-birth rate (78.0% and 85.5%) within the follow-up period. However, the rates for an abnormal chromosome karyotype in aborted concepti in cases with and without uterine anomalies were 15.4% (two of 13) and 57.5% (1 34 of 233), respectively, with the latter being significantly higher. The D/C ratio in the miscarriage group was also significantly greater than that for the live-birth group.Conclusion(S): Congenital uterine anomalies have a negative impact on reproductive outcome in couples with recurrent miscarriage and are associated with further miscarriage with a normal embryonic karyotype. The D/C ratio was found to have a predictive value for further miscarriages in recurrent cases. (Fertil Steril (R) 2010;93:1983-8. (C)2010 by American Society for Reproductive Medicine.)