Influence of hysteroscopic resection of septate uterus on reproductive prognosis and pregnancy

Septate uterus is one of the cogeni­tal abnormalities that causes the most problems. It is frequently the cause of spontaneous abor­tion, preterm labour, malpresentation or intrauter­ine growth retardation. Recently, hysteroscop­ic resection has been used to correction of this uterine malformation. The aim of the study was to determine how hysteroscopic metroplasty affects the capacity to conceive in women with a history of spontaneous abortions, and in pre­viously infertile women. We studied the course of pregnancy and labour, and the neonatal out­come in women who conceived after hysteroscopic metroplasty and in a control group with­out congenital anomalies of Muellerian system. Our retrospective study included 85 women treated by hysteroscopic metroplasty at the Department of Obstetrics and Gynecology, Ljubljana between 15th February 1993 and 30th June 1995. 94% of women with previous spon­taneous abortions and 55% of women with of his­tory of infertility became pregnant 12 to 24 months after hysteroscopic metroplasty, the overall number of pregnancy in both groups being 47 pregnancies. In 21 women (45%) preg­nancy ended in term delivery, in 2 (4%) in preterm delivery, and in 6 (13%) in spontaneous abortion. 3 (6%) women had extrauterine preg­nancy. At the time of the study 15 (32%) preg­nancies were still ongoing. No differences were found between the study group of 23 women who delivered after hysteroscopic metroplasty and the control group of 46 women without uterine anoalies as conserns the rate of complications during pregnancy and the caesarean sections, neona­tal outcome, birth weight, Apgar scores and other perinatal parameters. In the study group, there were only cephalic presentations. The results prove that hysteroscopic metroplasty does not affect the capasity to consive in women with a history of spontaneous abortions, and that it has a beneficial effect on reproductive outcome in infer­tile women. Hysteroscopic metroplasty enables women to have normal pregnancy and labour, and improves the outcome of pregnancy.