Les sections de cloisons et les plasties d'agrandissement ont-elles réellement un impact obstétrical ?

Garbin, O.; Ziane, A.; Castaigne, Vanina; Rongières, C

doi:10.1016/j.gyobfe.2006.07.027

Cited by 18 publications

(3 citation statements)

References 22 publications

(23 reference statements)

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“…This common pathology has been analyzed for the frequency of the uterine factor by several authors [15,16,17,18] for patients with 2 or more consecutive abortions. It ranges from 1 to 30%.…”

Section: Discussionmentioning

confidence: 99%

Term Delivery Rate after Hysteroscopic Metroplasty in Patients with Recurrent Spontaneous Abortion and T-Shaped, Arcuate and Septate Uterus

Giacomucci

Bellavia

Fabrizio

et al. 2010

Gynecol Obstet Invest

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Background: To evaluate the improvement of the term delivery rate after uterine surgery in various uterine malformations. Methods: 170 patients were eligible for the present retrospective case series study. Data were weighted for the number of pregnancies observed (n = 218) after surgical intervention, stratified to the number of previous abortions (at least 2) and type of malformation. Results: Before surgery, the overall term delivery rate was 5.5%. After surgery, the overall term delivery rate was 59% (absolute benefit increase, ABI, was 54.5) and correlated with the number of previous abortions (69.7% ABI = 64.2, 56.5% ABI = 51 and 26.3% ABI = 20.8 for 2, 3–4 and >4 abortions, respectively; p = 0.0008, log-rank test). Data stratified according to uterine malformations yielded the following term delivery rate: 66.7% for T-shaped uterus, 62.8% for septum/partial septum and 55.6% for arcuate uterus (NS, log-rank test). The number of previous abortions and maternal age also affected the term delivery rate. Their effect upon the term delivery rate, expressed as an odds ratio, was 1.73 (95% CI: 1.20–2.49) and 1.11 (95% CI: 1.05–1.18), respectively. Conclusion: The term delivery rate was about 10-fold higher after surgery. T-shaped uterus surgery yielded the best term delivery rate.

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Section: Discussionmentioning

confidence: 99%

Term Delivery Rate after Hysteroscopic Metroplasty in Patients with Recurrent Spontaneous Abortion and T-Shaped, Arcuate and Septate Uterus

Giacomucci

Bellavia

Fabrizio

et al. 2010

Gynecol Obstet Invest

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“…All findings were similar to those previously described by the literature. Garbin et al [ 16 ] suggest that the benefits of metroplasty go beyond the increase in compliance and enlargement of the uterine cavity; the vascularization of the fibrous walls is also improved by the formation of new blood vessels.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the proven success of HOME-DU, it is not yet clear whether it should be used as a front-line treatment for patients with uterine malformations and reproductive failure, even before assisted reproductive technology (ART) such as artificial insemination (AI) and in vitro fertilization (IVF) [ 7 , 16 ]. Once again, this is largely due to the subjective and arbitrary criteria used to diagnose said anomalies.…”

Section: Introductionmentioning

confidence: 99%

Dysmorphic Uteri: Obstetric Results after Hysteroscopic Office Metroplasty in Infertile and Recurrent Pregnancy Loss Patients. A Prospective Observational Study

Sánchez-Santiuste

Ríos

Calles

et al. 2020

JCM

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To compare the obstetric results achieved after hysteroscopic office metroplasty (HOME-DU) in infertile and recurrent pregnancy loss (RPL) patients diagnosed with dysmorphic uterus, women hysteroscopically diagnosed with dysmorphic uterus who underwent uterine-enlargement metroplasty were prospectively enrolled from June 2016 until April 2020. Patients were followed up and obstetric outcomes were recorded (pregnancy and live birth rate). Sixty-three women (30 infertile; 33 RPL) were enrolled, of which 48 became pregnant post-HOME-DU, with an overall pregnancy rate of 76.2% (66.7% among infertile participants; 84.9% among those with RPL). Overall, 64.3% (n = 36/63) achieved live birth. Among infertile women, 62.07% (n = 18/29) achieved live birth, as well as 66.7% of women with RPL (n = 18/27). The difference in live birth rates between both cohorts was 4.6% (p > 0.05). The rate of miscarriage amongst infertile patients was 3.3% (n = 1/30) and 12.1% amongst women with RPL (n = 4/33). Office metroplasty via the HOME-DU technique improves obstetric results (namely increasing live birth rate) in patients with dysmorphic uterus and a history of reproductive failure. No significant difference was found in the clinical efficacy of HOME-DU in infertile and RPL patients.

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Definition, prevalence, clinical relevance and treatment of T‐shaped uterus: systematic review

Neto

Ludwin

Martins³

2021

Ultrasound in Obstet & Gyne

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Objectives To summarize in a systematic review the current evidence regarding definitions, diagnosis, prevalence, etiology, clinical relevance and impact of surgical treatment for T‐shaped uterus not related to diethylstilbestrol (DES) exposure, and to highlight areas on which future research should focus. Methods A search of PubMed, Scopus and EMBASE was performed on 9 April 2020 using the search terms ‘t‐shaped OR t‐shape OR infantile OR (lateral indentation) OR (diethylstilbestrol OR DES) AND (uterus OR uterine OR uteri) AND (anomaly OR anomalies OR malformation OR malformations)’. Additionally, the reference lists of the included studies were searched manually for other relevant publications. All studies presenting data on T‐shaped uterus not associated with DES exposure and including at least 10 women were considered eligible. Studies regarding DES‐related T‐shaped uterus were excluded because DES has not been used since 1971. There were no restrictions on language, date of publication or status of publication. Results Of 2504 records identified by the electronic search, 20 studies were included in the systematic review. The majority of studies were of poor quality. In 11 of 16 studies reporting on the diagnosis of T‐shaped uterus, the diagnostic method used was three‐dimensional ultrasound. There is no consensus on the definition of T‐shaped uterus, but the most cited criteria (4/16 studies) were of the European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy (ESHRE/ESGE; 2013). The prevalence of T‐shaped uterus varied from 0.2% to 10% in the four included studies reporting such data. With respect to etiology (except for DES), T‐shaped uterus was considered a primary condition in three studies and secondary to adhesions in five and adenomyosis in one. T‐shaped uterus was related to worse reproductive outcome based on subfertility (nine studies), miscarriage (seven studies), preterm delivery (two studies), ectopic pregnancy (one study) and repeat implantation failure (seven studies). Of the 12 studies that reported on the effects of surgical treatment of T‐shaped uterus by hysteroscopic metroplasty, some mentioned an improvement in pregnancy rate (rates ranging from 49.6% to 88%; eight studies), live‐birth rate (rates ranging from 35.1% to 76%; seven studies) and term‐delivery rate (four studies) and a reduction in miscarriage (rates ranging from 7% to 49.6%; five studies) and ectopic pregnancy (one study). However, the evidence is of very low quality with serious/critical risk of bias toward overestimating the intervention effect. Some authors reported no complications related to the procedure, while others mentioned persistence of the dysmorphism (rates ranging from 1.4% to 11%; three studies), bleeding (1.3%; one study), infection (2.6%; one study) and adhesions (11.1% and 16.8%; two studies). Conclusions The prevalence, etiology and clinical relevance, with respect to reproductive outcome, of T‐shaped uterus remain unclear and there is no conse...

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Les sections de cloisons et les plasties d'agrandissement ont-elles réellement un impact obstétrical ?

Cited by 18 publications

References 22 publications

Term Delivery Rate after Hysteroscopic Metroplasty in Patients with Recurrent Spontaneous Abortion and T-Shaped, Arcuate and Septate Uterus

Term Delivery Rate after Hysteroscopic Metroplasty in Patients with Recurrent Spontaneous Abortion and T-Shaped, Arcuate and Septate Uterus

Dysmorphic Uteri: Obstetric Results after Hysteroscopic Office Metroplasty in Infertile and Recurrent Pregnancy Loss Patients. A Prospective Observational Study

Definition, prevalence, clinical relevance and treatment of T‐shaped uterus: systematic review

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