Uterine malformations and infertility.

Uterine malformation, stunting, endometritis, uterine fibroids, the intrauterine adhesions, abnormal uterine and endometrial dysfunction, can affect the operation of sperm, the fertilized egg implants and fetal development, growth, cause infertility or miscarriage. [Uterine malformations -- a cause. Deputy renal hypoplasia of derivatives. 2. Deputy mesonephric duct derivatives integration obstacles. [1] classification. Closed (1) to : residual uterine horn and intrauterine barrier sexual maturity after cyclical pain, which is often found before marriage, and take appropriate action. (2) Incomplete : remnant uterine horn and intrauterine environment, and no significant dysmenorrhea, but that more rudimentary uterine horn pregnancy. 2. Non-locking (1) double uterus (double uterus, cervix double, double vagina). (2) two-uterine cervical double (double uterine horn, double the cervix and vagina alone). (3) two-uterine cervical single (single two-uterine cervix). (4) Single Single uterine neck. (5) incomplete septate uterus. (6) fully septate uterus. [Clinical manifestations -- uterine malformations affect fertility, depending on the type of malformation and the extent to which. Most such patients without obvious symptoms, but often influence the fertilized egg implants cause infertility. Even pregnancy, intrauterine not increase. Prone abortion, premature. [Diagnosis -- according to infertility patients or repeatedly complained of abortion, combined with adjuvant more tests can be confirmed. Traditional diagnostic methods rely solely on the uterus, fallopian tube lipiodol contrast, a contrast that mainly rely abdomen, hysteroscopy and ultrasound, which could understand the type of uterine anomalies, but also visual appearance of uterine contour, to improve the accuracy of diagnosis. 【Treatment -- uterine malformations after diagnosis, treatment according malformation types were given different treatment. Where cents or double uterus malformation, although prone to premature or late abortion, but the pregnancy itself can promote uterine development, 50% of the rate of live births. If mediastinal or two-uterine malformations, intrauterine deformation, difficult pregnancy, even though pregnancy, abortion-prone, should consider surgery. 1. Laparotomy (1) Tompkin law : that is to cut open the uterus center, pruning mediastinum, Intrauterine layer for the closure. Apply to the septate uterus mediastinal were small. The method has the advantages of the preservation of all the uterine tissues. (2) Jones Act : that is, wedge resection of mediastinal law applicable to a wide mediastinum persons. (3) Strasman law : that is the bottom of uterine incision and then suture around applicable to the two-uterine malformations. Postoperative Note : (a) After the operation Add metal devices 9-12 months, an intrauterine prevent postoperative adhesions, two reached contraceptive purposes, uterine incision healing on schedule. (2) must contraception after 12 months. (3) after using estrogen and progestin therapy artificial cycle of three months to facilitate the repair of endometrial hyperplasia. prevent vaginal bleeding. (4) It is reported above three methods, pregnancy rate was as high as 90%, the rate of live births of up to 80%. Delivery to 36 weeks of pregnancy after elective Cesarean section suitable. 2. Hysteroscopy hysteroscopy address downlink mediastinal corrective surgery in recent years has been popular in China, The advantage is not delivered, uterine surface and deep muscle without incisions, without fear after pregnancy complications such as uterine rupture. But we must master surgical indications, the best in laparoscopic ultrasound or under guardianship. Central placed after birth control to prevent uterine adhesions.