Reproductive outcome, duration of pregnancy and mode of delivery after hysteroscopic metroplasty in patients with infertility

Abstract

Introduction: Reproductive outcome can be negatively affected in patients with congenital uterine anomalies (CUA), increasing the number of un- successful pregnancies and obstetric complications. Standard, safe and minimally invasive method for the treatment of correctible types of congenital uterine anomalies is hysteroscopic metroplasty (HM). The aim of the study was to analyze the reproduc- tive outcome, duration of pregnancy and mode of deli- very in group of patients with infertility after hystero- scopic metroplasty. Material and methods: We analyzed 48 patients with previous history of fetal loss (abortion) to whom hysteroscopy was done in the period of 01. 11. 2009 to 01. 05. 2013 year at the University Clinic of Obstetrics and Gynecology in Skopje. In patients who were diag- nosed having CUA hysteroscopic metroplasty was do- ne. Patients and their reproductive outcome were follo- wed for a period of at least 2 years after the interven- tion. Reproductive outcome was followed considering pregnancy rate, fetal loss (abortion) up to 22 gestatio- nal week, rates of preterm and term deliveries, live births and mode of delivery. Statistical analysis was performed using computer software and value for the confidence interval (± 95% CI) was considered to be statistically significant with level of p < 0.05. Results: After hysteroscopic metroplasty, there was a significant decrease of the abortion rate to 13.9%, and significant increase in pregnancy rates of 86.1%. Overall pregnancy rate was 75%, and term delivery was noted in 93,6% of the patients, with spontaneus deliveri- es in 58,6%. There were no complications during the hysteroscopic metroplasty, nor during the deliveries. Conclusion: Hysteroscopic metroplasty has a sig- nificant effect on the reproductive outcome, resulting in a large number of live births and no significant com- plication during consecutive pregnancy and delivery.