弓形子宫的诊治研究进展

doi:10.12280/gjszjk.20250320

摘要/Abstract

摘要：

弓形子宫是先天性子宫畸形中较为常见的一种，是米勒管融合过程中子宫中线隔膜的不完全吸收所致，表现为宫底内膜向宫腔的轻度凹陷。各研究中弓形子宫的诊断方法及诊断标准尚不统一，其宫底内膜凹陷深度通常<1 cm，凹陷中心点角度通常>90°，三维超声、磁共振成像、宫腔镜和（或）腹腔镜检查等可协助诊断。目前弓形子宫与不良妊娠结局的关系尚不明确，合并不孕、复发性流产或不良产科结局的弓形子宫患者可进行手术治疗，手术方式为宫腔镜弓形子宫成形术，但疗效存在争议。综述弓形子宫的定义与诊断标准、诊断方法、对妊娠结局的影响、手术治疗指征与术后妊娠结局，以期为弓形子宫的个体化诊治提供新思路，进一步提高女性生育力。

关键词: 先天畸形, 妊娠结局, 弓形子宫, 米勒管畸形, 三维超声

Abstract:

Arcuate uterus is a relatively common type of congenital uterine malformation, resulting from incomplete absorption of the median septum during the process of müllerian duct fusion. It is characterized by a mild indentation of the endometrium at the fundus into the uterine cavity. The diagnostic methods and criteria for arcuate uterus vary across studies. Typically, the depth of indentation of the endometrium at the fundus is less than 1 cm, and the central angle of the indentation is usually greater than 90 degrees. Three-dimensional ultrasonography, magnetic resonance imaging, hysteroscopy, and/or laparoscopy can aid in the diagnosis. The current relationship between arcuate uterus and adverse pregnancy outcomes remains unclear. The patients with arcuate uterus complicated by infertility, recurrent miscarriage, or poor obstetric outcomes may undergo surgical treatment, which is performed via hysteroscopic metroplasty for arcuate uterus. The therapeutic efficacy of surgery is a subject of controversy among different studies. In this article, we review the definition and diagnostic criteria, diagnostic methods, impact on pregnancy outcomes, surgical indications, and postoperative pregnancy outcomes of arcuate uterus, to offer new insights for the individualized diagnosis and treatment of arcuate uterus and further enhance female fertility.

Key words: Congenital abnormalities, Pregnancy outcome, Arcuate uterus, Müllerian anomalies, Three-dimensional ultrasound

张东璨, 何玲, 张慧英, 田文艳. 弓形子宫的诊治研究进展[J]. 国际生殖健康/计划生育杂志, 2025, 44(6): 506-510.

ZHANG Dong-can, HE Ling, ZHANG Hui-ying, TIAN Wen-yan. Research Progress on Diagnosis and Treatment of Arcuate Uterus[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(6): 506-510.

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