A New Outpatient Sub-Classification System for Patients with American Fertility Society (AFS) Classes V and VI of Uterine Anomalies

Gubbini, Giampietro; Casadio, Paolo; Nascetti, Daniela; Marra, Elena; Spinelli, Marialuigia; Sardo, Attilio Di Spiezio

doi:10.1016/j.jmig.2009.08.062

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“…Therefore, more than 50% patients need uterine septum resection before pregnancy. The incidence of septate uterus, type V of female genital tract malformation, is about 0.73-12% and accounts up to 80-90% of uterine malformation, caused by the absorption disorder after the fusion of bilateral accessory of embryonic nephridium [6,7]. Being less invasive, the hysteroscopy uterine septum resection (TCRS) is currently considered as an ideal and standard operation to resect uterine septum.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of intrauterine device placement or estrogen therapy to patients after hysteroscopic uterine septum resection

Xue¹,

Zhang²,

Cui³

et al. 2018

biomedicalresearch

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Whether the implement of Intrauterine Device (IUD) and/or Estrogen Replacement Therapy (ERT) is required for preventing intrauterine adhesion after transcervical hysteroscopic resection of uterine septum (TCRS) remains unclear, here, we report a retrospective cohort analysis of the outcomes of patients who had received different treatments after TCRS. Among the 223 cases received TCRS and/or postoperative treatments, the group A, B and C received TCRS at periods 2002-2007, 2007-2009 and 2009-2011 respectively. The group A of 74 patients was placed IUD for 2~3 months after operation. Group B of 63 patients was given ERT treatment for 2~3 cycles. Group C of 86 patients received neither IUD nor ERT. All of the patients were checked hysteroscopically for uterine cavity adhesions during the period of the third to the seventh days after the second menstruation. All pregnancies occurring during the observation period were recorded. The TCRS succeeded for all patients. None of them needed a twostage operation. Cavity membrane adhesion of uterine cavity formed in 3 cases, 2 cases and 2 cases in the groups A, B, C respectively. 194 of 223 patients got pregnant within one year after TCRS. 160 children had been delivered successfully. The live birth rate was 71.7% (160/223). The abortion rates after operation were 10 cases, 7 cases and 9 cases in A, B, C group respectively. Statistical analysis showed no significant differences in uterine adhesion, pregnancy rate, abortion frequency, live birth rate and the rate of cesarean section among the three groups. However, the postoperational cost of group C was significantly lower than that of groups A and B. In short, neither postoperational IUD placement, nor estrogen therapy, nor the combination of IUD and ERT demonstrated any discernible clinical benefits to the patients in preventing intrauterine adhesions and facilitating pregnancy after TCRS.

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Section: Introductionmentioning

confidence: 99%