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INFLUENCE OF HYSTEROSCOPIC METROPLASTY ON APPEARANCE, ONGOING AND OUTCOME OF PREGNANCY
Stjepan Skenderović
Asim Kurjak
Sanja Kupešić
Renato Bauman
Matija Prka
Sažetak
Objective. Ultrasound diagnostics and hysteroscopic technique made a hughe progress in accurate detection of failure of fusion of the Müllerian ducts and failure of resorption of the intervening septum, which are occuring during embryologic development from 6 to 20 weeks and result in formation of uterine septa of variable lengths and positions. These congenital uterine malformations are associated with poor reproductive outome and an increased risk for mother. Hysteroscopic metroplasty is minimally invasive procedure allowing safe technique for incision of the septum. The objective was to analyze the successfulness of the hysteroscopic metroplasty in the appearance, ongoing and outcome of the pregnancy. Material and methods. The group of 410 patients with pregnancy after hysteroscopic metroplasty was evaluated.¬ The mean age of patients was 31.4 years. The mean infertile interval was 5.3 years. Before hysteroscopic metroplasty 232 patients were referred with history of pregnancy loss or complications of pregnancy. Infertility was the main complaint in 178 patients. Results. Before hysteroscopic metroplasty delivery rate in the group of 232 patients with secondary infertility¬ was 7.6%, perinatal mortality rate 32.3% and spontaneous abortion rate 72.8%; total number of miscarriagies was 360, its number ranged 1–9 in studied 169 patients. Ectopic pregnancy rate was 10.8% (25 patients). In spite of the treatment lasting several years there were no pregnancies in the group of 178 patients. After hysteroscopic metroplasty, delivery rate increased significantly and reached 75.8%. Ongoing pregnancy rate is 8.5%. On the other hand, spontaneous abortion rate decreased significantly and dropped to 10.4%. Ectopic pregnancy rate decreased to 3.9%. Perinatal mortality decreased to 2.2%. Conclusion. Pregnancy capacity of the uterine cavity is enlarged by hysteroscopic incision of the septum. Conditions for implantation and embryo development are improved. Hysteroscopic metroplasty significantly increased delivery rate, from 7.6% before to 75.8% after the procedure. Rate od spontaneous abortions decreased¬ from 72.8% before operation to 10.4% and ectopic pregnancy rate from 10.8% to 3.9%.
Ključne riječi
septate uterus; hysteroscopy; metroplasty; miscarriage; infertility; pregnancy outcome
Hrčak ID:
15579
URI
Datum izdavanja:
1.6.2004.
Posjeta: 3.944 *