HYSTEROSCOPIC TREATMENT OF PARTIAL AND COMPLETE UTERINE SEPTUM

Objective-To review the experience with hysteroscopic treatment of ute rine septa, particularly those involving the cenix. Methods-One hundre d twenty-four patients with septate uterus were treated hysteroscopica lly. Seven of these women had a uterine septum involving the uterus an d cervix. All patients but nine who were infertile had demonstrated re petitive pregnancy losses with nothing to explain the reproductive fai lure but the uterine septation. The preoperative reproductive performa nce included 299 pregnancies, of which 258 were spontaneous abortions (86.6%) and 28 preterm pregnancies (9.6%) that resulted in viable infa nts. Results-Following treatment, 101 patients achieved pregnancy (81. 4%). There were 84 term pregnancies (83.1%) and 7 preterm viable pregn ancies (6.9%). There were 12 spontaneous abortions, all in the first t rimester (11.8%); 23 patients had not become pregnant as yet (18.5%). Of the seven patients with complete uterine septum, including the cerv ix, six had delivered an infant at term, one by cesarean section at 41 weeks because of breech presentation, and the other five by vaginal d elivery at 38, 371/2, 39, 40 and 39 weeks. Conclusion-Hysteroscopic tr eatment of the septate uterus can be extended to practically all types of uterine septa, including those involving the cervix.