Reproductive outcome following hysteroscopic treatment of the septate uterus: a result of 28 cases at Ramathibodi Hospital.

Abstract

We reported the reproductive outcome of 28 patients with septate uterus who underwent hysteroscopic metroplasty between August 1994 and October 1999 at Ramathibodi Hospital. The majority of septa were partial. Most of the patients had recurrent pregnancy losses. Division of the septum was performed with scissors in 7, a new device of Versapoint bipolar electrode in 10, and by means of resectoscope in 11 patients. The operating time varied from 45 to 70 minutes with an average time of 50+/-5.5 minutes which included the time for laparoscopy. The blood loss during the operation was minimal. All 28 patients were discharged a few hours after the operation. There were no serious complications attributed to this study. Most of the patients had minor spotting but no significant bleeding for a few days after hysteroscopic surgery. Of the 28 patients, 4 patients have not tried to conceive because of personal reasons, and the other 5 patients were lost to follow-up. Fifteen patients who had postoperative hysterosalpingograms, demonstrated a normal uterine cavity. There were a total of 20 pregnancies after a mean period of 24+/-1.4 (range 6-42) months following hysteroscopic treatment, of which 15(75.0%) were carried to term, 3(15.0%) were spontaneous abortions, and 2(10.0%) are in progress. The rate of pregnancy wastage in the post-treatment group was 15 per cent compared with 96.3 per cent in the pretreatment group.