Cravello L, Porcu G, Roger V, D'Ercole C, Blanc B
Service de Gynécologie-Obstétrique B, Hôpital de La Conception, CHU, Marseille.
Contracept Fertil Sex. 1998 Jul-Aug;26(7-8):589-92.
In the treatment of uterine lesions associated with infertility, such as septate uterus and synechiae, hysteroscopic surgery has replaced conventional abdominal surgery. Hysteroscopic metroplasty improves obstetrical prognosis in patients with septate uterus. Advantages of hysteroscopy are low morbidity rate, decreased hospitalization time, and absence of hysterotomy. Hysteroscopic surgery of synechiae allows to achieve good anatomical results in most of the cases. The first risk of this surgery is perforation. However, obstetrical results are uneven; pregnancy rates are low in cases of complex synechiae. Endometrial ablation is performed in patients presenting with abnormal uterine bleeding after failure of progestin therapy. Pregnancies following endometrial ablation have been described; term deliveries are still exceptional.
在治疗与不孕相关的子宫病变时，如纵隔子宫和粘连，宫腔镜手术已取代传统的腹部手术。宫腔镜子宫成形术可改善纵隔子宫患者的产科预后。宫腔镜的优点是发病率低、住院时间缩短且无需进行子宫切开术。大多数情况下，宫腔镜粘连手术能取得良好的解剖学效果。该手术的首要风险是穿孔。然而，产科结果参差不齐；复杂粘连病例的妊娠率较低。对于孕激素治疗失败后出现异常子宫出血的患者，可进行子宫内膜消融术。已有关于子宫内膜消融术后妊娠的报道；足月分娩仍属罕见。
