Staff Physician, Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy.
Professor, Department of Public Health, University of Naples "Federico II," Naples, Italy.
Obstet Gynecol Surv. 2020 Jul;75(7):431-444. doi: 10.1097/OGX.0000000000000807.
To date, a comprehensive review on the safety and effectiveness of hysteroscopic metroplasty for T-shaped uterus is still missing.
To provide a robust synthesis of the available studies investigating reproductive outcomes after hysteroscopic metroplasty for T-shaped uterus.
We performed a systematic review and meta-analysis (CRD42019143291), using the proportion method with 95% confidence interval (CI). Statistical heterogeneity was assessed by Higgins test ().
We included 11 cohort studies embedding 937 women who underwent hysteroscopic metroplasty. After surgery, the pooled percentage of live birth was 44.54% (95% CI, 36.12%-53.12%; = 46.22%) and 56.88% (95% CI, 46.48%-66.98%; = 36.38%) in women with primary infertility and recurrent miscarriage, respectively. In women with recurrent miscarriage, the pooled proportion of miscarriage was 21.46% (95% CI, 15.09%-28.61%; = 30.18%). The pooled clinical pregnancy proportion in women with primary infertility was 57.19% (95% CI, 43.83%-70.03%; = 77.81%). The pooled rate of surgical complications was 0.65% (95% CI, 0.20%-1.33%; = 11.44%).
The hysteroscopic correction of T-shaped uteri was associated with high live birth rate and low miscarriage rate, both in case of primary infertility and recurrent miscarriage.
Hysteroscopic metroplasty can be considered a safe and effective strategy to improve reproductive outcomes in case of T-shaped uterus.
迄今为止，关于 T 形子宫宫腔镜子宫整形术的安全性和有效性的综合综述仍然缺失。
提供对 T 形子宫宫腔镜子宫整形术后生殖结局的现有研究的综合分析。
我们进行了系统评价和荟萃分析（CRD42019143291），使用比例法和 95%置信区间（CI）。统计异质性通过 Higgins 检验（）进行评估。
我们纳入了 11 项队列研究，共纳入 937 名接受宫腔镜子宫整形术的女性。手术后，原发性不孕和复发性流产女性的活产率分别为 44.54%（95%CI，36.12%-53.12%；=46.22%）和 56.88%（95%CI，46.48%-66.98%；=36.38%）。在复发性流产的女性中，流产的合并比例为 21.46%（95%CI，15.09%-28.61%；=30.18%）。原发性不孕女性的临床妊娠合并比例为 57.19%（95%CI，43.83%-70.03%；=77.81%）。原发性不孕女性的手术并发症发生率为 0.65%（95%CI，0.20%-1.33%；=11.44%）。
T 形子宫的宫腔镜矫正术与高活产率和低流产率相关，无论是原发性不孕还是复发性流产。
宫腔镜子宫整形术可被视为改善 T 形子宫生殖结局的一种安全有效的策略。
