生殖医学杂志2025，Vol.34Issue(6)：784-789,6.DOI:10.3969/j.issn.1004-3845.2025.06.009
基于三维超声比较纵隔子宫不同诊断标准的临床意义
Clinical significance of comparing different diagnostic criteria for septate uterus based on three-dimensional ultrasound
摘要
Abstract
Objective:To investigate the differences in clinical diagnostic rates and clinical significance among various diagnostic criteria for septate uterus. Methods:This study was a secondary analysis of preoperative basic data from a multicenter randomized clinical trial,including 251 patients diagnosed with septate uterus according to the ESHRE/ESGE-2016 criteria from 10 tertiary hospitals between May 2020 and April 2022.The uterine septum-related parameters were measured by three-dimensional ultrasound coronal imaging.Differences in infertility and miscarriage rates were compared among the patients meeting each different diagnostic criterion.Based on septal morphology,patients were classified into two groups with septal angle ≥90°(obtuse-angle septum group,n=74)and septal angle＜90°(acute-angle septum group,n=177).Infertility and spontaneous miscarriage rates were compared between the two groups.And the association between effective uterine cavity area and patients' history of infertility and spontaneous miscarriage rates was explored. Results:Using the ESHRE/ESGE-2016 diagnostic criteria as a reference,the diagnostic rates for septate uterus based on the ASRM-2016,CUME-2018 and ASRM-2021 were 60.16％(151/251),90.04％(226/251),and 70.92％(178/251),respectively.There were no significant differences in infertility or miscarriage rates among patients diagnosed with septate uterus using these four criteria(P＞0.05).For each diagnostic criterion,there was no significant difference in spontaneous miscarriage rates between patients who met and did not meet the criteria(P＞0.05).There were no significant differences in infertility or spontaneous miscarriage rates between the acute-angle and obtuse-angle septum groups(P＞0.05).Additionally,among the 165 patients with septate uterus who had a history of pregnancy,there was no significant difference in effective uterine cavity area between those with and without a history of spontaneous miscarriage. Conclusions:Overall,the diagnostic criteria of CUME-2018 may be the most suitable.Restricting diagnosis based on the septal angle may lead to missed cases.关键词
纵隔子宫/三维超声/诊断标准/纵隔夹角/妊娠结局Key words
Septate uterus/Three-dimensional ultrasound/Diagnostic criteria/Septal angle/Pregnancy outcome分类
临床医学引用本文复制引用
赵子辰,陈娜,朱兰,邓姗..基于三维超声比较纵隔子宫不同诊断标准的临床意义[J].生殖医学杂志,2025,34(6):784-789,6.基金项目
国家重点研发计划重点专项项目(2021YFC2701405) （2021YFC2701405）
国家临床重点专科建设项目(U114000) （U114000）
