A méhüreg anatómiai rendellenességei habituális vetélőkben

Abstract

Bevezetés: A habituális vetélés a nők 1%-át érintő rendellenesség, amelynek hátterében genetikai, endokrin, méhűri anatómiai, immunológiai, mikrobiológiai és hematológiai, valamint andrológiai zavarok mutathatók ki mint kocká-zati tényezők, de az esetek felében ismeretlen ok miatt alakul ki. Célkitűzés: A habituális vetélés kockázati tényezőinek kutatása során a szerzők arra a kérdésre kerestek választ, vajon a magyar lakosságban milyen gyakran fordul elő a méhüreget érintő anatómiai rendellenesség. Módszer: Retrospektív módon dolgozták fel 152 habituális vetélő adatait. Az esetleges méhűri eltérés tisztázására 132 betegben vagy diagnosztikus hiszteroszkópia, vagy a méhüreg 3 dimenziós ultrahangvizsgálata, 16 esetben hysterosalpingographia, 4 esetben hysterosalpingo-sonographia történt. Eredmények: Megállapították, hogy a habituális vetélők 15,8%-ában méhűri rendellenesség mutatható ki. A rendellenességek közül septum uteri 6,5%-ban, endometriumpolypus 2,6%-ban, uterus arcuatus 2%-ban, uterus bicornis 2%-ban, submucosus myomagöb 1,3%-ban és méhűri synechiák 1,3%-ban fordultak elő. Következtetések: A szerzők megfi gyelése arra utal, hogy habituális vetélésben szenvedő nőkben a méhüreg morfológiai rendellenessége gyakori. Ilyen esetekben javasolt a méhüreg anatómiai vizsgálata. Orv. Hetil., 2015, 156(27), 1081-1084. Kulcsszavak: habituális vetélés, méhűri rendellenesség Uterine anomalies in women with recurrent pregnancy lossIntroduction: One percent of couples trying to have children are affected by recurrent miscarriage. These pregnancy losses have different pathogenetic (genetic, endocrine, anatomic, immunologic, microbiologic, haematologic and andrologic) backgrounds, but recurrent miscarriage remains unexplained in more than half of the affected couples. Aim: To explore risk factors for recurrent pregnancy loss the authors studied the incidence of anatomic disorders of the uterine cavity occur in Hungarian women with recurrent miscarriage. Method: Medical records of 152 patients with recurrent miscarriage were analyzed retrospectively. In order to explore disorders of the uterine cavity hysteroscopy or 3-dimensional sonography in 132 women, hysterosalpingography in 16 and hysterosalpingo-sonography in 4 patients were used. Results: Incidence of anomalies in the uterine cavity was found in women with recurrent miscarriage to be 15.8%. A variety of the uterine anomalies was found including uterine septum in 6.5%, endometrial polyp in 2.6%, arcuate and bicornuate uteri both in 2% and 2%, submucosal myoma in 1.3 %, and intrauterine synechiae in 1.3%. Conclusions: These fi ndings suggest that morphologic disorder of the uterine cavity is frequent in Hungarian women with recurrent miscarriage. Therefore, assessment of the uterine anatomy is recommended in such patients.

Reproductive Factors and Risk of Spontaneous Abortion in the Jinchang Cohort

“…Abnormal anatomical structure of uterus is a risk factor for spontaneous abortion. Uterine septum, endometrial polyp and uterine fibro can change the normal structure and local environment of the uterine cavity, resulting in reduced embryo implantation area and endometrial blood flow, increasing blood flow resistance, thereby affecting embryo implantation and growth and fetal development [ 11 ]. Adenomyosis can release the inflammatory mediator, stimulate the local part of the embryo, and stimulate the contraction of the uterus by producing prostaglandins, which leads to abortion.…”

Before Is Better: Innovative Multidisciplinary Preconception Care in Different Clinical Contexts

“…Maternal anatomical alterations can explain 15-42% of cases of RPL [78]. Among congenital uterine malformations, the septate uterus can be found in 6-16% of women affected by RPL [79]. Three-dimensional ultrasound is an accurate and noninvasive method for the diagnosis of congenital uterine malformations [80].…”

Success Rates of Vaginal Sonography and Hysteroscopy for Diagnosis of Intrauterine Pathologies in Female Infertility

“…Despite medical advances, uterine pathologies remain unknown in many cases with serious consequences such as infertility [1]. Septate uterus, dysmorphic uterus, dysfused uterus, unilateral formed uterus, aplastic or dysplastic uterus uterine septum, endometrial polyps, arcuate and bicornuate uteri, and myomas are pathologies that cause repeated miscarriage in addition to clinical complications [2,3]. Various devices, including hysteroscopy and transvaginal sonography (TVS), can diagnose intrauterine pathologies [4].…”