Clinical Analysis Of Hysteroscopy In Patients With A Uterine Septum

Objective In recent years, many domestic and international literature has reported the hysteroscopic treatment of uterine septum to improve the prognosis of pregnancy have a clear effect,but there had no domestic in Qingdao,and the uterine morphology ability to impact on pregnancy relative lack of research. This article analyze the uterine septum hysteroscopic treatment results comprehensively,understanding of pregnancy after hysteroscopic uterine septum resection and its conception of time from the surgery,as well as miscarriage, premature delivery and other symptoms. The effect of hysteroscopic uterine septum resection and pregnancy before and after the surgery were analyzed, comparing before and after surgery, the pregnancy rate, adverse pregnancy incidence and the time of its first conception distance surgery, as well as during the pregnancy after threatened abortion incidence were analyzed.Methods Retrospectively,116cases of uterine septum were analyzed, which were collected from our hospital from June2004to June2011. All the cases were diagnosed as uterine septa before operation by B-ultrasound combined with hysteroscopy. All the patients were treated with hysteroscopic transcerbical resection of septa being monitored by laparoscopy. Comparing before and after surgery, the pregnancy rate, adverse pregnancy incidence and the time of its first conception distance surgery, as well as during the pregnancy after threatened abortion incidence were analyzed.Results1.In partial uterine septum, the incidence of spontaneous abortions decreased from preoperative73.77%to postoperative5.88%. The missed abortion rate decreased from preoperative22.95%to postoperative8.22%. The term-live delivery rate increased from preoperative3.28%to postoperative85.29%. There were highly significant difference(p<0.001).The infertile rate decreased from23.08%to10.53%, compared preoperation with postoperation. This difference was also significant(p<0.05). In complete uterine septum,the incidence of spontaneous abortions decreased from preoperative66.67%to postoperative5.88%. The term-live delivery rate increased from preoperative0%to postoperative88.24%. There were highly significant difference(p<0.001).The infertile rate increased from41.18%to17.65%, compared preoperation with postoperation. This difference was also significant(p<0.05).The missed abortion rate decreased from preoperative16.67%to postoperative5.88%. This difference has no statistical significance (p>0.05).2.The postoperative peak period of pregnancy mainly concentrated in6-12months after operation, after1years not only reduce the rate of conception, and higher risk of threatened abortion during pregnancy.Conclusion1.Complete uterine septum mainly were performed infertility and spontaneous abortions, in contrast, embryonic spontaneous abortions and spontaneous abortions for partial uterine septum.2.Patients with uterine septum has a very low live birth rate and the adverse pregnancy rate was higher, therefore, should be timely surgical treatment.3.Hysteroscopic transcerbical resection of septa (TCRS) is ideal for the treatment of uterine septum, which can significantly improve the pregnancy outcome. For patients with recurrent pregnancy loss, the operation can obviously improve the reproductive outcome of patients. The group of complete uterine septum is better than the group of partial uterine septum on the effect of surgical treatment.4.The postoperative peak period of pregnancy mainly concentrated in6-12months after operation, after1years not only reduce the rate of conception, and higher risk of threatened abortion during pregnancy.