Metroplasty And Reproductive Outcome Of Complete Septate Uterus With Cervical Duplication: An Analysis Of 27 Cases

Objectives: To review the diagnosis and treatment of septate uterus, while referring to the recently abroad ideas about complete septate uterus with cervical duplication. To improve the insight of complete septate uterus with cervical duplication and put forward a preliminary scheme for clinical disposal for women suffering from complete septate uterus with cervical duplication.Methods: We collected the data of 27 inpatients who had undergone metroplasty from our hospital with the diagnosis of complete septate uterus with cervical duplication during January, 1997 and December, 2006. We retrospectively analyzed the relatively clinical manifestation, diagnosis, Metroplasty and reproductive outcome. Diagnoses were obtained with physical examination, HSG, sonography, laparoscopy or/and hysteroscopy, and surgical evaluation. All of them underwent sonography before surgery. 7 underwent abdominal septum resection , while 20 hysteroscopic metroplasty.Result: 12 of the 27 patients had delivery history for 27 times, 8 of them with spontaneous abortion problem for 14 times, 13 of them with infertility. 7of 27 underwent HSG with accuracy of 14.3%. 27 of 27 underwent sonography, with accuracy of 88.9%. 7 underwent abdominal septum resection , while 20 hysteroscopic metroplasty. The Latter needed less operating time, had less intraoperative bleeding, and needed less hospital time. 22 of 27 were followed up , 6 contraception , 9 failedto be pregnancy, 7 were pregnant (43.75%) for 8 times, without spontaneous abortion. 6 of the 8 pregnancys(75%), had term delivery with living birth. All of the 6 pregnancy terminated pregnancy by cesarean section. The rate of spontaneous abortion decreased, P＜0.01. The rate of term delivery increased, P＜0.01. The differences of the rate of pregnancy showed no statistically significant, P>0.05. Conclusions: septate uterus is often combining with problems in fertility and delivery, especilly with infertility and spontaneous abortion, so is complete septate uterus with cervical duplication. Sonography can advance the preliminary diagnosis. Hysteroscopic metroplasty combining with sonography or laparoscopy is recommended. Those with problems in delivery requires metroplasty.