Rochet Y, Dargent D, Seffert P, Brémond A, Rudigoz R C, Marin M, Verbaere S
J Gynecol Obstet Biol Reprod (Paris). 1985;14(2):227-37.
The authors present a series of 45 plastic operations for bicornuate uterus. Three women were operated on for functional symptoms, eight for sterility of which seven were primary, and thirty four for infertility. They are sorry that three women were lost to follow up. They used the Bret-Palmer technique with modifications that they themselves describe. They justify this choice as against other techniques of metroplasty. The anatomical results are, in the main, good when controlled by hysterosalpingography 3 to 6 months after the operation. The functional results, by which is meant the pregnancies that have been obtained, are medium as far as sterility is concerned. Four out of the eight women who were operated on became pregnant. But they are very good in cases of infertility, because thirty out of the thirty four cases that were operated on had one or two pregnancies. The authors justify their indications for metroplasty after a first spontaneous abortion by the good results they have had, and because bicornuate uteri give rise to many obstetrical complications. Furthermore in unoperated cases there is often difficulty in attempting a new pregnancy, and quite often spontaneous late abortions or premature labours. In certain cases they carried out the operation after first spontaneous abortions, but they are more conservative in operating in cases of primary sterility. The authors do not think it is necessary always to carry out a cerclage procedure nor a caesarean operation automatically in cases that have become pregnant after metroplasty.
作者介绍了一系列针对双角子宫的45例整形手术。3名女性因功能性症状接受手术，8名因不育接受手术，其中7名是原发性不育，34名因不孕接受手术。他们很遗憾有3名女性失访。他们采用了经自己描述改良后的布雷特 - 帕尔默技术。他们解释选择该技术而非其他子宫成形术技术的理由。术后3至6个月通过子宫输卵管造影检查时，解剖学结果总体良好。就不育而言，功能性结果（即已获得的妊娠情况）一般。接受手术的8名女性中有4名怀孕。但在不孕病例中结果很好，因为接受手术的34例中有30例有过一次或两次妊娠。作者通过所取得的良好结果以及双角子宫会引发许多产科并发症来证明首次自然流产后进行子宫成形术的适应证。此外，在未手术的病例中，再次尝试怀孕往往困难重重，而且经常会出现晚期自然流产或早产。在某些情况下，他们在首次自然流产后进行手术，但在原发性不育病例的手术中更为保守。作者认为在子宫成形术后怀孕的病例中并非总是有必要常规进行宫颈环扎术或剖宫产手术。
