PREGNANCY AFTER METROPLASTY FOR UTERINE ANOMALIES

Objective: To clarify the relation between metroplasty for correction of uterine anomalies and subsequent pregnancy, we reviewed the charts of all patients for whom a diagnosis of bicornuate, septate, or didelp hic uterus had been made between 1972 and 1982 and analyzed their obst etric outcomes. Design: Of the 146 patients evaluated, 23 received a m etroplasty procedure, and 123 patients did not have surgical intervent ion. Fifteen of the nonsurgical patients could be matched with 15 of t he surgical patients by age, chief complaint, gravidity, and type of a nomaly and therefore served as matched controls.Results: The percentag e of patients with living children after the diagnosis of uterine anom aly was 67% for the matched nonsurgical group and 73% for the patients who underwent metroplasty. The difference was not statistically signi ficant. Although marked improvement in fetal salvage rates war, noted when reproductive outcomes before and after metroplasty were compared, the obstetric outcome was similar to that of the control groups after the diagnosis was made and surgery deferred. Conclusion: The efficacy of metroplasty in the treatment of multiple pregnancy losses is thus being questioned.