Daly D C, Walters C A, Soto-Albors C E, Riddick D H
Fertil Steril. 1983 May;39(5):623-8. doi: 10.1016/s0015-0282(16)47056-1.
Congenital Müllerian abnormalities, particularly the septate uterus, may result in recurrent abortion or premature labor. Twenty-five patients found to have a septate uterus during evaluation for infertility or recurrent abortion were treated by hysteroscopic metroplasty with laparoscopic visualization. Surgical outcome was excellent, intraoperative and postoperative morbidity was negligible, and the postoperative course was similar to that following laparoscopy alone. Preoperative fetal wastage in 17 previously fertile patients was 90%. Of 11 patients, 6 or more months postoperatively, 10 had conceived: 5 delivered vaginally at term, 2 delivered by cesarean section, and 2 pregnancies are in progress. One pregnancy miscarried at 21 weeks secondary to an incompetent cervix. With hysteroscopic metroplasty, septa can be incised successfully with lower morbidity and as good a surgical outcome as with abdominal procedures. If further studies confirm the pregnancy outcome reported, then hysteroscopic metroplasty should become the treatment of choice for the septate uterus.
先天性苗勒管异常，尤其是纵隔子宫，可能导致反复流产或早产。25例在不孕或反复流产评估中发现纵隔子宫的患者接受了宫腔镜子宫成形术并辅以腹腔镜可视化治疗。手术效果极佳，术中和术后发病率可忽略不计，术后病程与单纯腹腔镜检查相似。17例既往有生育能力的患者术前胎儿丢失率为90%。11例患者术后6个月或更长时间，10例已怀孕：5例足月顺产，2例剖宫产，2例妊娠仍在继续。1例妊娠在21周时因宫颈机能不全流产。通过宫腔镜子宫成形术，纵隔可成功切开，发病率较低，手术效果与腹部手术相当。如果进一步的研究证实了所报道的妊娠结局，那么宫腔镜子宫成形术应成为纵隔子宫的首选治疗方法。
