HYSTEROSCOPIC METROPLASTY

Hysteroscopic metroplasty seems to be the treatment of choice for sept ate uterus with recurrent abortion and associated infertility. The pre sent study evaluates the efficacy of hysteroscopic metroplasty in rest oring normal morphology of the uterine cavity and evaluates the reprod uctive results in those patients who were infertile. Ten hysteroscopic metroplasties were performed. Three patients had never conceived befo re operation, seven had two to three spontaneous abortions. The uterin e septum was complete in two cases, partial in eight. The procedure wa s carried out easily. All the patients received danazol 800 mg/day for 7 to 11 days before surgery, starting from day 1 of menstrual cycle. Oestrogen supplementation was given after surgery. At follow-up hyster oscopy, seven patients had a normal uterine cavity and three a residua l fundal notch >1 cm; incomplete septae were corrected during the proc edure. Seven patients conceived after operation, four have already del ivered, three pregnancies are ongoing. Septate uterus should be accept ed as cause of recurrent abortion after excluding other aetiologic fac tors. Abdominal metroplasty for septate uterus has been superseded by hysteroscopic metroplasty because of the short hospitalization require d, reduced morbidity, low risk of pelvic adhesions, and possibility of subsequent vaginal delivery. In our small preliminary series the repr oductive outcome was excellent.