Improved Fetal Salvage after Metroplasty

Reproductive prognosis after abdominal metroplasty in bicornuate or septate uterus: a life table analysis

“…Likewise Musich and Behrman (1978) studied 12 women with scptate and 10 with bicornuatc uteri, obtaining, respectively, six and four pregnancies after metroplasty. Similar findings were reportcd from the United States (Capraro et al 1968;Rock & Jones 1977;Thompson etal. 1966) Finland (Heinonen et al 1982), Switzerland (Kascr 1981 and Japan (Kusuda 1982).…”

Reproductive Uterine Surgery

“…Semmens 9 reported "only" 35% wastage among his patients with hemiuterus and 49% in those with septate or bicornuate uteri. In his whole series, Capraro 22 had a similar 38% abortion rate and a total 46% fetal loss rate. Septate uterus had fewer surviving infants (41%) than bicornuate uterus (61%).…”

“…In his review, 26% of patients undergoing surgery had menorrhagia as one of their indications. On the other hand, Musich 21 reported only 2 of 49 patients had menorrhagia, and Capraro and associates 22 found menorrhagia in only 8 of 85 patients. Kistner 5 concludes that, although a uterine septum might contribute to irregular or heavy bleeding, this symptom alone is a "rare indication" for surgery.…”

“…Dunselman 23 reported 54 cases of metroplasty performed for infertility; following operation 32 (58%) became pregnant. Capraro 22 stated that "sterility itself is not an indication unless other causes of infertility have been ruled out." Only 1 of his 14 cases was performed for infertility.…”

“…Although hysteroscopic septal resection obviates the need for cesarean delivery, most obstetricians elect for operative delivery after abdominal metroplasty. In his most recent review, Jones 34 stressed the long, disappointing obstetric history of these patients, and felt that operative delivery to de- E. Strassmann 20 Capraro 22 Buttram 27 Rock, Jones 29 Musich crease the chance of rupture was a reasonable approach. However, it should be remembered that Paul Strassmann's first patient had six vaginal deliveries following her surgery, and that vaginal delivery was the norm following the procedure until cesarean delivery became safer and, therefore, most common in the last 20 years.…”