摘要
Objective: To determine if sectioning of the cervical septum in hysteroscopic metroplasty of the complete uterine septum is associated with intraoperative bleeding, cervical incompetence, and secondary infertility. Design: Multicenter, randomized, controlled clinical trial. Setting: University hospitals. Patient(s): Twenty-eight women with a diagnosis of complete uterine septum who had a history of pregnancy wastage or infertility. They were randomized into two groups: group A underwent metroplasty including section of the cervical septum; group B underwent the same procedure with preservation of the cervical septum. Intervention(s): Hysteroscopic metroplasty was performed for all patients in the two groups. Main Outcome Measure(s): Operating time, distending media deficit, total distending media used, intraoperative bleeding, complications, and reproductive outcome. Result(s): Operating times were 36.40 ± 10.67 minutes and 73 ± 14.40 minutes in group A and group B, respectively. Distending media deficit was 456.66 ± 165.68m Lin group A,while in groupB it was 673.84± 220.36. Two cases of pulmonary edema and three cases of significant bleeding ( > 150 mL)were seen in group B. The cesarean section rate was significantly higher in group B. There were no signifi cant differences in the reproductive outcome in the two groups. Conclusion(s): Resection of the cervical septum during hysteroscopic metroplasty of complete uterine septum makes the procedure safer, easier, and less complicated than the procedure with preservation of the cervical septum. This procedure is recommended for all cases of complete uterine septum.
Objective: To determine if sectioning of the cervical septum in hysteroscopic metroplasty of the complete uterine septum is associated with intraoperative bleeding, cervical incompetence, and secondary infertility. Design: Multicenter, randomized, controlled clinical trial. Setting: University hospitals. Patient(s): Twenty-eight women with a diagnosis of complete uterine septum who had a history of pregnancy wastage or infertility. They were randomized into two groups: group A underwent metroplasty including section of the cervical septum; group B underwent the same procedure with preservation of the cervical septum. Intervention(s): Hysteroscopic metroplasty was performed for all patients in the two groups. Main Outcome Measure(s): Operating time, distending media deficit, total distending media used, intraoperative bleeding, complications, and reproductive outcome. Result(s): Operating times were 36.40 ± 10.67 minutes and 73 ± 14.40 minutes in group A and group B, respectively. Distending media deficit was 456.66 ± 165.68m Lin group A,while in groupB it was 673.84± 220.36. Two cases of pulmonary edema and three cases of significant bleeding ( > 150 mL)were seen in group B. The cesarean section rate was significantly higher in group B. There were no signifi cant differences in the reproductive outcome in the two groups. Conclusion(s): Resection of the cervical septum during hysteroscopic metroplasty of complete uterine septum makes the procedure safer, easier, and less complicated than the procedure with preservation of the cervical septum. This procedure is recommended for all cases of complete uterine septum.
