马菁苒;朱兰;

• 1:中国医学科学院 北京协和医学院 北京协和医院儿科
• 2:中国医学科学院 北京协和医学院 北京协和医院妇产科

摘要(Abstract)：

<正>先天性子宫畸形是女性生殖系统常见畸形类型,本文对其多个分类系统、诊断和不同类型的鉴别进行综述,以便更好地指导临床治疗和评估预后。先天性子宫畸形的分类先天性子宫畸形通常是由于先天性苗勒管发育异常(Müllerian duct anormalies,MDAs)所致。从发生学上讲,MDAs可分为3种类型:苗勒管发育不全、侧方融合缺陷、垂直融合缺陷;MDAs可导致原发性闭经、不孕、产科并发症、子宫内膜异位症等妇产科疾病。先天性子宫畸形常伴有其他器官畸形如肾脏畸形、骨骼畸形、听力障碍等,但是与卵巢畸形关

关键词(KeyWords)： 先天性子宫畸形;苗勒管发育异常;分类;诊断

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 马菁苒;朱兰;

参考文献(References)：

• [1]Behr SC,Courtier JL,Qayyum A.Imaging of müllerian duct anomalies[J].Radiographics,2012,32:E233-E250.
• [2]Santos XM,Krishnamurthy R,Bercaw-Pratt JL,et al.The utility of ultrasound and magnetic resonance imaging versus surgery for the characterization of müllerian anomalies in the pediatric and adolescent population[J].J Pediatr Adolesc Gynecol,2012,25:181-184.
• [3]The American Fertility Society classifications of adnexal adhesions,distal tubal occlusion,tubal occlusion secondary to tubal ligation,tubal pregnancies,müllerian anomalies and intrauterine adhesions[J].Fertil Steril,1988,49:944.
• [4]Salim R,Woelfer B,Backos M,et al.Reproducibility of three-dimensional ultrasound diagnosis of congenital uterine anomalies[J].Ultrasound Obstet Gynecol,2003,21:578-582.
• [5]Deutch TD,Abuhamad AZ.The role of 3-dimensional ultrasonography and magnetic resonance imaging in the diagnosis of müllerian duct anomalies:a review of the literature[J].J Ultrasound Med,2008,27:413-423.
• [6]Gergolet M,Campo R,Verdenik I,et al.No clinical relevance of the height of fundal indentation in subseptate or arcuate uterus:a prospective study[J].Reprod Biomed Online,2012,24:576-582.
• [7]Mucowski SJ,Herndon CN,Rosen MP.The arcuate uterine anomaly:a critical appraisal of its diagnostic and clinical relevance[J].Obstet Gynecol Surv,2010,65:449-454.
• [8]Acién P,Acién M,Sánchez-Ferrer M.Complex malformations of the female genital tract.New types and revision of classification[J].Hum Reprod,2004,19:2377.
• [9]Oppelt P,Renner SP,Brucker S,et al.The VCUAM(Vagina Cervix Uterus Adnex-associated Malformation)classification:a new classification for genital malformations[J].Fertil Steril,2005,84:1493-1497.
• [10]Saravelos SH,Cocksedge KA,Li TC.Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure:a critical appraisal[J].Hum Reprod Update,2008,14:415-429.
• [11]Mazouni C,Girard G,Deter R,et al.Diagnosis of Mullerian anomalies in adults:evaluation of practice[J].Fertil Steril,2008,89:219-222.
• [12]Bermejo C,Martínez Ten P,Cantarero R,et al.Three-dimensional ultrasound in the diagnosis of Müllerian duct anomalies and concordance with magnetic resonance imaging[J].Ultrasound Obstet Gynecol,2010,35:593.
• [13]Bocca SM,Abuhamad AZ.Use of 3-dimensional sonography to assess uterine anomalies[J].J Ultrasound Med,2013,32:1-6.
• [14]Chan YY,Jayaprakasan K,Zamora J,et al.The prevalence of congenital uterine anomalies in unselected and high-risk populations:a systematic review[J].Hum Reprod Update,2011,17:761-771.
• [15]Ludwin A,Pityński K,Ludwin I,et al.Two-and three-dimensional ultrasonography and sonohysterography versus hysteroscopy with laparoscopy in the differential diagnosis of septate,bicornuate,and arcuate uteri[J].J Minim Invasive Gynecol,2013,20:90-99.
• [16]Acholonu UC,Silberzweig J,Stein DE,et al.Hysterosalpingography versus sonohysterography for intrauterine abnormalities[J].JSLS,2011,15:471-474.
• [17]Ludwin A,Ludwin I,Banas T,et al.Diagnostic accuracy of sonohysterography,hysterosalpingography and diagnostic hysteroscopy in diagnosis of arcuate,septate and bicornuate uterus[J].J Obstet Gynaecol Res,2011,37:178-186.
• [18]Caliskan E,Ozkan S,Cakiroglu Y,et al.Diagnostic accuracy of real-time 3D sonography in the diagnosis of congenital Mullerian anomalies in high-risk patients with respect to the phase of the menstrual cycle[J].J Clin Ultrasound,2010,38:123-127.
• [19]Hajishaiha M,Ghasemi-Rad M,Karimpour N,et al.Transvaginal sonographic evaluation at different menstrual cycle phases in diagnosis of uterine lesions[J].Int J Womens Health,2011,3:353-357.
• [20]Niknejadi M,Haghighi H,Ahmadi F,et al.Diagnostic accuracy of transvaginal sonography in the detection of uterine abnormalities in infertile women[J].Iran J Radiol,2012,9:139-144.
• [21]Troiano RN,McCarthy SM.Mullerian duct anomalies:imaging and clinical issues[J].Radiology,2004,233:19-34.
• [22]Olpin JD,Heilbrun M.Imaging of Mullerian duct anomalies[J].Clin Obstet Gynecol,2009,52:40-56.
• [23]Shulman LP.Mullerian anomalies[J].Clin Obstet Gynecol,2008,51:214-222.
• [24]Ghi T,Casadio P,Kuleva M,et al.Accuracy of three-dimen-sional ultrasound in diagnosis and classification of congenital uterine anomalies[J].Fertil Steril,2009,92:808-813.
• [25]Salim R,Woelfer B,Backos M,et al.Reproducibility of threedimensional ultrasound diagnosis of congenital uterine anomalies[J].Ultrasound Obstet Gynecol,2003,21:578-582.
• [26]Moini A,Mohammadi S,Hosseini R,et al.Accuracy of3-dimensional sonography for diagnosis and classification of congenital uterine anomalies[J].J Ultrasound Med,2013,32:923-927.
• [27]Faivre E,Fernandez H,Deffieux X,et al.Accuracy of three-dimensional ultrasonography in differential diagnosis of septate and bicornuate uterus compared with office hysteroscopy and pelvic magnetic resonance imaging[J].J Minim Invasive Gynecol,2012,19:101-106.
• [28]Abuhamad AZ,Singleton S,Zhao Y,et al.The Z technique:an easy approach to the display of the mid-coronal plane of the uterus in volume sonography[J].J Ultrasound Med,2006,25:607-612.
• [29]Terry S,Banks E,Harris K,et al.Comparison of 3-dimensional with 2-dimensional saline infusion sonohysterograms for the evaluation of intrauterine abnormalities[J].J Clin Ultrasound,2009,37:258-262.
• [30]Bij de Vaate AJ,Brlmann HA,van der Slikke JW,et al.Gel instillation sonohysterography(GIS)and saline contrast sonohysterography(SCSH):comparison of two diagnostic techniques[J].Ultrasound Obstet Gynecol,2010,35:486-489.
• [31]Dzotsenidze TN,Davarashvili DI,Nikolaishvili TG,et al.Contrast sono hysterosalpingography in the study of endometrial abnormalities and tubal patency in infertile patients[J].Georgian Med News,2006,(139):61-63.
• [32]Shokeir T,Abdelshaheed M.Sonohysterography as a first-line evaluation for uterine abnormalities in women with recurrent failed in vitro fertilization-embryo transfer[J].Fertil Steril,2009,91:1321-1322.
• [33]Kupesic S,Plavsic BM.2D and 3D hysterosalpingo-contrastsonography in the assessment of uterine cavity and tubal pa-tency[J].Eur J Obstet Gynecol Reprod Biol,2007,133:64-69.
• [34]Church DG,Vancil JM,Vasanawala SS.Magnetic resonance imaging for uterine and vaginal anomalies[J].Curr Opin Obstet Gynecol,2009,21:379-389.
• [35]Marcal L,Nothaft MA,Coelho F,et al.Mullerian duct anomalies:MR imaging[J].Abdom Imaging,2011,36:756-764.
• [36]Mueller GC,Hussain HK,Smith YR,et al.Müllerian Duct Anomalies:comparison of MRI diagnosis and clinical diagnosis[J].Am J Roentgenol,2007,189:1294-1302.
• [37]Taylor E,Gomel V.The uterus and fertility[J].Fertil Steril,2008,89:1-16.
• [38]Dendrinos S,Grigoriou O,Sakkas EG,et al.Hysteroscopy in the evaluation of habitual abortions[J].Eur J Contracept Reprod Health Care,2008,13:198-200.
• [39]Smit JG,Kasius JC,Eijkemans MJ,et al.The international agreement study on the diagnosis of the septate uterus at office hysteroscopy in infertile patients[J].Fertil Steril,2013,99:2108-2113.
• [40]Bettocchi S,Ceci O,Nappi L,et al.Office hysteroscopic metroplasty:“three diagnostic criteria”to differentiate between septate and bicornuate uteri[J].J Minim Invasive Gynecol,2007,14:324-328.
• [41]Cooper NA,Smith P,Khan KS,et al.A systematic review of the effect of the distension medium on pain during outpatient hysteroscopy[J].Fertil Steril,2011,95:264-271.
• [42]Koskas M,Mergui JL,Yazbeck C,et al.Office hysteroscopy for infertility:a series of 557 consecutive cases[J].Obstet Gynecol Int,2010,2010:168096.
• [43]El-Mazny A,Abou-Salem N,El-Sherbiny W,et al.Outpatient hysteroscopy:a routine investigation before assisted reproductive techniques?[J].Fertil Steril,2011,95:272-276.