Medical Journal of The Islamic Republic of Iran (MJIRI)

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Congenital Mullerian abnormalities, particularly the septate uterus, may result in recurrent abortion, premature labor and infertility. The purpose of this study is to report the surgical and reproductive outcome in two groups of patients who underwent hysteroscopic metroplasty (HMP). Between Aug. 1993 and March 1998,76 women underwent HMP in Shiraz University of Medical Sciences' affiliated hospitals. They were divided into two groups. Group one received no postoperative (post-op) additional therapy. Group two received post-op estrogen, and an IUD was also placed to prevent post-op endometrial adhesion. They were analyzed with respect to post-op complications and reproductive outcome. Seven of these patients had a complete uterine septum which extended through the cervix and to the vagina. All of the seven cervical septums were incised with good obstetrical outcome. There were a total of 45 pregnancies during 6 months or more post-op in the two groups. Differences between the reproductive outcome of the two groups was not statistically significant (p=O.90066) and the general results were as follows: term delivery rate was 35 (72.7%),23 (51%) delivered vaginally, and 12 (26.5%) delivered by cesarean section (CIS) for obstetric indications,4 (8.8%) were spontaneous abortions and one immature delivery at 16 wks due to premature rupture of membranes (PROM). Intraoperative and post-op morbidity was negligible. We concluded that with HMP, septa can be incised successfully, post-op hormonal therapy and IUD placement are not needed, the cervical septum can be incised without any post-op complication, and a good reproductive outcome can be expected.

Keywords: Uterus, abnonnalities, management, hysteroscopic metroplasty.

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