Hysteroscopy in Uterine Anomalies: A Boon!

Abstract

Introduction The incidence of congenital uterine malformations is as high as 3 to 4% with septate uterus being one of the most common forms of congenital malformation. Structurally anomalous uterus has been recognized as a cause of infertility, and obstetric complications. Of all known uterine anomalies, septate uterus is the most common and is associated with poorest reproductive outcome, with fetal survival rates between 6 to 28%. Also, it carries high rate of spontaneous miscarriage exceeding > 60% but, on the bright side, it is one of the uterine anomaly that is most amenable via simple hysteroscopic management. Aims and objectives To describe a case series (comprising two cases) septate uterus managed successfully using hysteroscopy. Background Septate uterus results from incomplete resorption of paramesonephric mullerian ducts during the first trimester of pregnancy. Depending on the size of septum, it can be incomplete septum or complete septum dividing the uterine cavity into two separate components including two cervix and vaginal septum. Congenital malformations may be associated with recurrent pregnancy loss, preterm labor, abnormal fetal presentation, intrauterine growth restriction (IUGR) and infertility. Hysteroscopy is considered the gold standard for the assessment and treatment of intrauterine anomalies. Cases Authors report two cases of septate uterus managed hysteroscopically. • A case of complete septate uterus and another case of complete septate uterus with two cervices, managed hysteroscopically both subjects conceived successfully after treatment. Conclusion Operative hysteroscopy is an effective and safe minimally invasive technique to manage complete uterine septum, associated with quicker recovery. Additionally, there is no scar formation which promotes improved reproductive outcome. It has enabled more liberalized approach to treatment, i.e. now being extended to include patients with recurrent pregnancy loss and premature labor. Also, this intervention can be used successfully in patients diagnosed with infertility secondary to uterine septations, especially if in vitro fertilization (IVF) is being contemplated. How to cite this article Pathak C, Manchanda R, Yadav G. Hysteroscopy in Uterine Anomalies: A Boon! J South Asian Feder Obst Gynae 2016;8(1):74-76.