Hysteroscopic treatment of partial and complete uterine septum.

OBJECTIVE

To review the experience with hysteroscopic treatment of uterine septa, particularly those involving the cervix.

METHODS

One hundred twenty-four patients with septate uterus were treated hysteroscopically. Seven of these women had a uterine septum involving the uterus and cervix. All patients but nine who were infertile had demonstrated repetitive pregnancy losses with nothing to explain the reproductive failure but the uterine septation. The preoperative reproductive performance included 299 pregnancies, of which 258 were spontaneous abortions (86.6%) and 28 preterm pregnancies (9.6%) that resulted in viable infants.

RESULTS

Following treatment, 101 patients achieved pregnancy (81.4%). There were 84 term pregnancies (83.1%) and 7 preterm viable pregnancies (6.9%). There were 12 spontaneous abortions, all in the first trimester (11.8%); 23 patients had not become pregnant as yet (18.5%). Of the seven patients with complete uterine septum, including the cervix, six had delivered an infant at term, one by cesarean section at 41 weeks because of breech presentation, and the other five by vaginal delivery at 38, 37 1/2, 39, 40 and 39 weeks.

CONCLUSION

Hysteroscopic treatment of the septate uterus can be extended to practically all types of uterine septa, including those involving the cervix.