Uterine Synechiae and Pregnancy Complications
Uterine Synechiae and Pregnancy Complications
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DOI：
10.1097/aog.0b013e31824be28a
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发表时间：
2012-04-01
影响因子：
7.2
通讯作者：
Cahill, Alison
中科院分区：
文献类型：
--
作者：
Tuuli, Methodius G.;Shanks, Anthony;Cahill, Alison
目的：子宫粘连通常被认为是妊娠期的良性表现。我们使用了一个大的围产期数据库来检验子宫粘连与妊娠并发症相关的假设。方法：我们对1990-2009年17-22周进行常规超声检查的单胎妊娠妇女进行了回顾性队列研究。排除多胎妊娠、羊膜带和先天性子宫畸形。我们比较了有和没有子宫粘连的妇女的妊娠结局。结果：在符合纳入标准的65,518例妊娠中，296例（0.45%）被诊断为子宫粘连。有子宫粘连的妇女更容易发生胎盘脱垂，（2.1%对比0.6%，校正比值比[OR] 3.25，95%置信区间[CI] 1.43-7.36），早产胎膜早破（PROM）（5.5%与2.3%，调整后OR 2.51，95%CI 1.51-4.18），以及因胎位不正而剖腹产（5.1%与3.0%，调整后OR 1.75，95%CI 1.04-2.95）。前置胎盘、胎儿生长受限、死胎和早产的风险无显著差异。结论：子宫粘连与早产胎膜早破、胎盘早剥和剖宫产的风险显著增加有关。妊娠期子宫粘连作为良性病变的观点应重新评价。（Obstet Gynecol 2012;119：810-4）DOI：10.1097/AOG.0b013e31824be28a
OBJECTIVE: Uterine synechiae have generally been considered benign findings in pregnancy. We used a large perinatal database to test the hypothesis that uterine synechiae are associated with pregnancy complications.METHODS: We performed a retrospective cohort study of women with singleton pregnancies presenting for routine ultrasonographic examinations at 17-22 weeks from 1990-2009. Pregnancies with multiple fetuses, amniotic bands, and congenital uterine anomalies were excluded. We compared pregnancy outcomes between women with and without uterine synechiae. Multivariable logistic regression was used to adjust for confounders.RESULTS: Of 65,518 pregnancies meeting inclusion criteria, 296 (0.45%) were diagnosed with uterine synechiae. Women with uterine synechiae were significantly more likely to have placental abruption (2.1% compared with 0.6%, adjusted odds ratio [OR] 3.25, 95% confidence interval [CI] 1.43-7.36), preterm premature rupture of membranes (PROM) (5.5% compared with 2.3%, adjusted OR 2.51, 95% CI 1.51-4.18), and cesarean delivery for malpresentation (5.1% compared with 3.0%, adjusted OR 1.75, 95% CI 1.04-2.95). The risks of placenta previa, fetal growth restriction, stillbirth, and preterm delivery were not significantly different.CONCLUSION: Uterine synechiae are associated with significant increase in the risk of preterm PROM, placental abruption, and cesarean delivery for malpresentation. The notion of uterine synechiae as benign findings in pregnancy should be re-evaluated. (Obstet Gynecol 2012;119:810-4) DOI: 10.1097/AOG.0b013e31824be28a