79: Arcuate or Minimally Septate Uterus: Diagnosis and Treatment

Abstract

To evaluate the diagnosis and efficacy of treatment in arcuate uteri. Evaluation of patients with two or more abortions and fundal curvature >5<15mm, diagnosed by transvaginal ultrasound, 3D ultrasound and diagnostic Hysteroscopy, before and after hysteroscopic metroplasty. Obstetric and gynecologic dept of University Hospital in Rome Italy. Twenty-three patients with two or more spontaneous abortions without term pregnancies and uterine fundal curvature depth between 5 and 15 mm. Resectosope transection of uterine fundal curvature. No perforation or other major complication occurred. Eighteen patients became pregnant till now and 13 (72%) had a term pregnancy, while 4 (22%) aborted and 1 (5.5%) had a preterm delivery at 30 week. Arcuate uterus is a separate class in AFS classification of uterine malformations, but the limits and differences with partial septum and normal uterus are not well defined. For these reasons the reproductive impairment of arcuate uteri is till controversial. In our work we selected and treated patients with reproductive failure and fundal curvature between 5 and 15 mm, obtaining 72 % of term pregnancies. Our preliminary results show that TVUS with 3D and diagnostic hysteroscopy can select patients with a history of repeated abortions and uterine fundal curvature that can increase their reproductive outcome with hysteroscopic metroplasty.