Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies

被引:186
作者
Venetis, Christos A. [1 ,2 ]
Papadopoulos, Stamatis P. [1 ]
Campo, Rudi [3 ]
Gordts, Stephan [4 ]
Tarlatzis, Basil C. [1 ]
Grimbizis, Grigoris F. [1 ,3 ]
机构
[1] Aristotle Univ Thessaloniki, Sch Med, Dept Obstet & Gynecol 1, GR-54006 Thessaloniki, Greece
[2] Univ New S Wales, Sch Womens & Childrens Hlth, UNSW Med, Sydney, NSW, Australia
[3] European Acad Gynecol Surg, Sci Project Female Genital Tract Congenital Anoma, B-3000 Leuven, Belgium
[4] European Soc Gynecol Surg, Special Interest Grp Reprod Surg, Project Congenital Uterine Anomalies CONUTA, B-3000 Leuven, Belgium
关键词
congenital uterine anomaly; miscarriage; obstetric outcome; pregnancy; treatment; HYSTEROSCOPIC METROPLASTY; MULLERIAN ANOMALIES; REPRODUCTIVE-PERFORMANCE; SEPTATE UTERUS; VAGINAL BIRTH; WOMEN; PREGNANCY; SEPTUM; PREVALENCE; CLASSIFICATION;
D O I
10.1016/j.rbmo.2014.09.006
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
The clinical implications of congenital uterine anomalies (CUA), and the benefits of hysteroscopic resection of a uterine septum, were evaluated. Studies comparing reproductive and obstetric outcome of patients with and without CUA and of patients who had and had not undergone hysteroscopic resection of a uterine septum, were evaluated. Meta-analysis of studies indicated that the pregnancy rate was decreased in women with CUA (RR 0.85, 95% CI 0.73 to 1.00; marginally significant finding, P = 0.05). The spontaneous abortion rate was increased in women with CUA (RR 1.68, 95% CI 1.31 to 2.15). Preterm delivery rates (RR 2.21, 95% CI 1.59 to 3.08), malpresentation at delivery (RR 4.75, 95% CI 3.29 to 6.84), low birth weight (RR 1.93, 95% CI 1.50 to 2.49) and perinatal mortality rates (RR 2.43, 95% CI 1.34 to 4.42) were significantly higher in women with CUA. Hysteroscopic removal of a septum was associated with a reduced probability of spontaneous abortion (RR 0.37, 95% CI 0.25 to 0.55) compared with untreated women. Presence of CUA might be associated with a detrimental effect on the probability of pregnancy achievement, spontaneous abortion and obstetric outcome. Hysteroscopic removal of a septum may reduce the probability of a spontaneous abortion. (C) 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:665 / 683
页数:19
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