分担課題:子宮奇形を持つ反復流産患者の妊娠帰結調査

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䈒䇮ᧄ⎇ⓥ䈪ೋ䉄䈩ᚻⴚ䊶㕖ᚻⴚ䈱Ყセ䈏಴᧪䈢ᗧ
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䉏䈳ᚻⴚ䈱ᓇ㗀䈲䈘䈾䈬ᄢ䈐䈇䈫⠨䈋䈭䈒䈩䈇䈇䈫ᕁ
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ఽ₪ᓧ₸䈏ᡷༀ䈪䈐䈭䈇䈖䈫䈏᣿䉌䈎䈮䈭䈦䈢䇯㩷
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਎⇇ᮡḰ⊛ၮḰ䈏ሽ࿷䈚䈭䈇䇯䉁䈢䇮ᧄ⎇ⓥ䈱ᣉ⸳
䈪䈱⸻ᢿᣇᴺ䇮ⴚᑼ䈱⛔৻䉅࿎㔍䈪䈅䈦䈢䇯䈢䈣䈚䇮
ሶችᄸᒻ䉕 㪉㪉㪎 ੱ㓸䉄䈩⸃ᨆ䈚䈢⎇ⓥ䈫䈇䈉ⷞὐ䈪
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䈮∝଀ᢙ䈱ᄙ䈇 㪺㪸㫊㪼㪄㪺㫆㫅㫋㫉㫆㫃㩷㫊㫋㫌㪻㫐 䈏ᓙ䈢䉏䉎䇯㩷
㩷
䌅䋮⚿⺰㩷
㩷 ਛ㓒ሶች䈮ኻ䈜䉎ౝⷞ㏜⊛ਛ㓒ಾ㒰ⴚ䈲↢ఽ₪
ᓧ䈱䈢䉄䈮᦭ല䈪䈅䉎䇯෺ⷺሶች䈮ኻ䈜䉎ᒻᚑⴚ䈱
᦭ലᕈ䈲᣿䉌䈎䈮䈪䈐䈭䈎䈦䈢䇯㩷
㩷
䌆䋮ஜᐽෂ㒾ᖱႎ㩷
䈭䈚㩷
㩷
䌇䋮⎇ⓥ⊒⴫㩷
㪈㪅 ⺰ᢥ⊒⴫㩷
ᛩⓂਛ㩷
㪉㪅 ቇળ⊒⴫㩷
⊒⴫Ḱ஻ਛ㩷
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Table 1
Baseline characteristics of patients with congenital uterine anomalies
Patients
receiving
Patients
receiving
p
surgery
no surgery
(n=147)
(n=80)
33.0 (4.5)
32.0 (4.3)
NS
2.73 (1.59)
2.68 (1.04)
NS
0
16
2
1
4
2
2
52
35
3
35
28
4
25
8
5
9
4
6
1
1
7
4
0
8
0
0
9
1
0
0.22 (0.60)
0.13 (0.43)
0
123
73
1
19
4
2
4
3
5
1
0
No. of previous live
0.12 (0.44)
0.09 (0.28)
0
133
73
1
12
7
3
2
0
0.97 (1.0)
0.74 (0.74)
Maternal age
Mean (SD)
Number of previous
miscarriages
No.
of
previous
NS
stillbirths
NS
births*
The
D/C
ratio
NS
before surgery
*Including preterm births
63
Table 2 Comparison of successful pregnancy outcomes between patients with and
without surgery
Bicornuate (n=56)
Septum (n=145)
p
With
Without
surgery
surgery
surgery
(n=19)
(n=37)
(n=127)
(n=18)
Mean age (SD)
32.0 (4.0)
31.1 (4.3)
NS
33.0 (4.2)
33.2 (4.1)
NS
No. of previous
2.79 (1.99)
2.80 (1.11)
NS
2.72 (1.54)
2.89 (1.05)
NS
0.37 (1.16)
0.14 (0.49)
NS
0.20 (0.47)
0.11 (0.32)
NS
0.16 (0.37)
0.06 (0.24)
NS
0.12 (0.45)
0.11 (0.32)
NS
14
34*
115**
15
Live birth rate
66.7 %
75.0 %
81.3 %
53.8 %
at
(8/12)
(21/28)
(78/96)
(7/13)
0/0
1/4
1/1
2/3
2 (14.3 %)
2 (6.7 %)
14
2 (13.3 %)
NS
85.4 %
61.5 %
0.049
(82/96)
(8/13)
74.5 %
53.3 %
(82/110)
(8/15)
With
Without
surgery
p
miscarriages
No. of previous
stillbirths
No. of previous
live births
No. of patients
who
could
be
followed up
the
first
NS
0.025
pregnancy after
examination
Abnormal
embryonic
karyotype
Infertile
after
NS
diagnosis***
(12.7 %)
Cumulative live
75.0 %
82.1 %
birth rate
(9/12)
(23/28)
Cumulative live
64.3 %
76.7 %
birth
(9/14)***
(23/30)
rate
per
NS
NS
0.086
patient
*One patient with a bicornuate uterus was terminated at 20 weeks’ gestation because of fetal anomaly.
One patient with a bicornuate uterus and translocation miscarried because of unbalanced
chromosomes.
**One couple did not try to conceive. These cases were all excluded from the analysis.
***Infertile was determined as not pregnant after one year trying to conceive.
7 patients are trying to conceive now. We could not follow up outcomes of 27 patients after diagnosis.
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