OP19.05: Three dimensional echographic evaluation of septate uterus after hysteroscopic septum resection and correlation with pregnancy outcome

Abstract

Septate uterus is associated with an increased incidence of reproductive failure. Hysteroscopic metroplasty improves reproductive outcome. The aim of the study was to evaluate the uterine cavity after hysteroscopic resection of septum using 3D transvaginal ultrasound and to correlate with pregnancy outcome. Our study contains 31 patients with a history of recurrent miscarriage and septate uterus diagnosed by 3D transvaginal ultrasound and were enrolled after hysteroscopic resection of the septum. The 3D transvaginal ultrasound was done again 3 months after surgery and the septum length and width were measured on the coronal plane in multiplanar aquisition to exclude the presence of residual septum. The septum length was decreased after surgery. In 45% patients a residual septum tissue between 5 mm and 10 mm was observed and in 50% of the patients the residual septum was more than 10 mm. Among patients with residual septum more than 10 mm, 50% miscarried again. Among patients with residual septum between 5 and 10 mm 46% had full term pregnancy and 15% had preterm deliveries, 6% had abortion. Three dimensional transvaginal ultrasound should be the first choice technique to quantify uterine residual septa after hysteroscopic methroplasty.