| Objective Summarize the general data of patients with uterine septum in the past 10 years,explored the influence on the reproductive prognosis of patients from the changes in the aspect of surgical indications and surgical procedure.Methods Retrospective analysis on the clinical data of patients with septatel uterus diagnosed in Ningxia Medical University General Hospital from January 2009 to December2018,and divided into partial septate uterus group(n=300)and complete septate uterus group(n=220),sub-divided each group into non-surgical group and surgical group,and made further divided surgical group into transcervical resection of septu group(TCRS)and transcervical incision of septu group(TCIS),and do a follow-up regarding their reproductive prognosis.Results 1 、 There were no statistic differences in age,body mass index(BMI),gynecological complications(fallopian tube disease,polycystic ovarian syndrome(PCOS),ovarian tumor,pelvic adhesion,endometriosis)and medical complications(diabetes,high blood pressure,thyroid disease)of enrolled patients.2 、 Data of previous pregnancy:compared to incomplete uterein septus group,there are high rates of the recurrent abortion rate(48.0% vs 47.3%)and live birth rate(16.3% vs 12.3%)and lower rate of preterm birth in complete uterein septus group(P<0.05).3、Data of intraoperative and postoperative parameters:Incomplete septate uterus group: compared to TCRS,TCIS method decreaseed operative time(30.77 ±9.61 vs 48.45 ± 10.63),blood loss(9.60 ± 13.68 vs 35.50 ± 40.75),consumption of uterus distension medium(1409.23±530.53 vs 2145.99±1674.79)and hospital stays(2.65±1.18 vs 4.63±1.20)(P<0.05),there were no statistic differences in intraoperative complication(uterine perforation and water intoxication)(P>0.05);Complete septate uterus group: compared to TCRS,TCIS method decreaseed operative time(29.41±9.05 vs 47.43±9.87),blood loss(8.56±5.77 vs 28.93±30.34),consumption of uterus distension medium(1396.77±582.99 vs 2377.56±2270.83)and hospital stays(2.56±1.22 vs 4.34±1.08)(P<0.05).4、Data of postoperative complication: Incomplete septate uterus group:compared the TCIS group with TCRS group in the Intrauterine adhesion(7.7% vs 18.0%)and residual septum after operation(3.8% vs 20.0%),TCIS group was lower than TCRS group(P<0.05),There was no statistic difference in cervical incompetence between two methods(P>0.05);Complete septate uterus group:compared the TCIS group with TCRS group in the Intrauterine adhesion(8.6% vs 19.6%)and residual septum after operation(3.2% vs 19.6%),TCIS group was lower than TCRS group(P<0.05),there was no statistic difference in cervical incompetence between two methods(P > 0.05).5 、 Date of pregnancy postoperative between conservative group and operation group: Incomplete septate uterus group:compared to TCRS group and conservative group,TCIS group increased natural conception rate(47.7% vs34.0% vs 28.6%),assisted reproductive rate(18.5% vs 12.0% vs 0.0%)and term labor rates(31.5% vs 19.0%vs 1.4%),but decreaseed miscarriage rate(9.2% vs 16.0% vs 21.4%)(P<0.05),there were no statistic differences in preterm birth rate between eath other(P>0.05).Complete septate uterus group: compared to TCRS group and conservative group,TCIS method increased natural conception rate(59.1% vs 34.6% vs30.0%),assisted reproductive rate(18.3% vs 9.3% vs 0.0%)and term labor rates(39.8% vs 9.3% vs 5.0%),and decreaseed miscarriage rate(16.1% vs 22.4% vs 25.0%)(P<0.05),there were no statistic differences in preterm birth rate(P>0.05).6、Two types of uterine septum: the mean time of first pregnancy after TCIS was shorter than TCRS method(P<0.05),however there was no statistic difference in obsteric complication(P>0.05).Conclusion 1.Complete septate uterus are more likely to get adverse reproductive outcomes than partial septate uterus.2.The septate uterus can obtain higher reproductive prognosis by surgical correction.3.TCIS is better than TCRS in reducing intrauterine adhesion and improving reproductive prognosis. |
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