OBSTETRICAL PROGNOSIS OF THE SEPTATE UTERUS - A PLEA FOR TREATMENT OFTHE SEPTUM

Objective: To evaluate the obstetrical and perinatal implications of t he septate uterus and assess the improvements of the prognosis after t reatment of the septum. Investigation: This retrospective investigatio n was carried out in a single centre on 78 patients with septate uteru s who had previously been correctly classified. A total of 203 pregnan cies were observed. All complications occurring during the first, seco nd and third trimesters and the neonatal outcome were logged. Furtherm ore, 25 patients in this sample underwent surgery which enabled reasse ssment of the obstetric and neonatal outcome. Results. Prior to surger y, during the 203 pregnancies, the fetal loss rate during the first tw o trimesters was 47%, prematurity 17% and 89 children were alive, i.e. an overall perinatal mortality rate of 16.8% when pregnancy exceeded 24 weeks. After surgical treatment of the septum, the proportion of pr egnancies proceeding subsequent to 24 weeks and infant survival change d, respectively, from 13.3% to 90% and from 4.4% to 87.5%. Conclusion: The obstetric and neonatal prognosis of septate uteruses is extremely unfavourable. This is radically transformed by treating the septum.