REPRODUCTIVE OUTCOME AFTER HYSTEROSCOPIC METROPLASTY

Objective: To evaluate the reproductive outcome after hysteroscopic me troplasty. Study design: We analysed the reproductive outcome of 69 pa tients, with different degrees of septate uterus, undergoing hysterosc opic metroplasty in the outpatient infertility clinic of Naples 'Feder ico II' University. Of the 69 patients, 48 had a history of recurrent abortion while 21 had a primary infertility. In all cases the procedur e was performed by means of the resectoscope. Results: In 97. 1% of th e cases post-operative hysterosalpingogram or hysteroscopic examinatio n showed a normal cavity with a little fundal notch. In two cases, sec ond surgery was needed. Of the 48 patients affected by repeated aborti on, 40 became pregnant after the metroplasty whereas, to date, in the infertile group only six out 21 (29.0%) conceived. We observed a total of 46 pregnancies with two sets of twins. Of these, 31 pregnancies (6 7.4%) were carried to term, five (10.8%) ended in preterm delivery, si x (13%) ended in spontaneous abortion and four (8.6%) are in progress. Cervical cerclage was performed on 13 women. Only one (7.6%) woman wi th cervical cerclage had a preterm delivery, while the preterm deliver y rate in women without cerclage was 12.1%. The modality of term pregn ancy deliveries was caesarian section in 48% of the cases and vaginal delivery in the 52%. Conclusions: Our data analysis suggest that the c orrection of mullerian anomalies does not improve the pregnancy rate, but only the pregnancy outcome of the patients.