Reproductive performance of women with uterine anomalies after abdominal or hysteroscopic metroplasty or no surgical treatment

Abstract

The reproductive outcome of 404 women with confirmed uterine malformations was studied. The most common uterine anomaly was complete or incomplete septate uterus (48%). Bicornuate uterus was found in 17% of women, and unicornuate and didelphic both in 10%. The fetal survival rates without metroplasty were 70% for the partially bicornuate group, and 76% and 63% for the septate and subseptate groups, respectively. Metroplasty was performed in 64 (26%) of 247 women with a septate, subseptate, or partially bicornuate uterine abnormality. The indication for operation in most women was recurrent spontaneous abortions. Abdominal metroplasty (Strassmann or Jones procedure) was carried out in 12 (22%) of 55 women with a partially bicornuate uterus. Metroplasty was done in 52 (27%) of 192 women with a septate or subseptate uterus. Abdominal metroplasty (Jones or Tompkins procedure) was used in 20 patients, and transcervical metroplasty by means of hysteroscopic scissors or resectoscopic division in 32. In all, the reproductive outcome improved from 9% successful pregnancies before to 84% after metroplasty.