| Objective: To explore the clinical effect of the diagnosis and treatment in uterine septum by hysteroscopy,B-Ultrasound and laparoscopy . Material and Methods : From August 2000 to August 2003,forty-threecases of uterine septum were performed with different diagnosis methods by hysteroscopy,B-Ultrasound and treatment effect with transcervical hysteroscopic resection of septum ( TCRS) controlled by laparoscopy. Results :1. The accuracy of transvaginal sonography (TVS)indiagnosing septate uterum was 90.70% and that ofhysteroscopy was 93.02%.2. While TCRS was made under hysteroscopy combined with lapaoscopy,the other lesions in both uterine and pelvic cavity were treated .There were no complications caused by hysteroscopy combined with lapaoscopy.3. In these cases of uterine septum, the incidence of spontaneous abortions decreased from preoperative 91.43% to postoperative 30.77%, The term-live delivery rate increased from preoperative 4.29% to postoperative 46.15%. There were highly significant difference (p<0.01); The infertile rate decreased from 44.19% to 20.69%, compared preoperation with postoperation. This difference was also significant (p<0.05).Conclusions:1 .It appears justified to use TVS as the initial method to diagnose uterine septa because of an unwounded and highly accurate tool. Hysterocopy is an essential process before metroplasty of uterine septa so as to further improve the diagnosis accuracy.2. Combined with laparoscopy ,the hysteroscopic metroplasty is the gold standard for assessing uterine septa,whichcan not only diagnose and treat endometriosis and other disease in pelvic cavity ,but also play a role in controlling the operation.3.Transcervical hysteroscopic resection of septum ( TCRS) can decrease significently the incidence of spontaneous abortions and the infertile rate.In the same time,it can increase the term-live delivery rate, so reproductive outcome was improved obviously for cases of uterine septum by the treatment. |
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