Successful Pregnancy Outcome after Open Strassman Metroplasty for Bicornuate Uterus

Gulavi, Edgar; Mutiso, Steve Kyende; Muriuki, Charles Mariara; Mwaniki, Abraham Mukaindo

doi:10.1155/2018/4579736

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…A fundal uterine incision is done, followed by dissection layer by layer until reaching the endometrium and then apposition of the two uterine horns followed by uterine suturing in layers. [ 36 ] Nabeshima et al . reported the case of laparoscopic Strassman procedure in a 12-year-old girl diagnosed with incomplete OHVIRA syndrome, with the absence of hemivaginal septum.…”

Section: Discussionmentioning

confidence: 99%

Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: A Systematic Review about Diagnosis and Surgical Management

Moufawad,

Giannini,

D’Oria

et al. 2023

Gynecology and Minimally Invasive Therapy

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Obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome is a rare congenital defect of the Müllerian ducts characterized by uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. The aim of this systematic review is to summarize the main symptoms and presentation of the OHVIRA syndrome, as well as the different types of management, fertility, and obstetrical outcomes. A comprehensive search was performed in PubMed, EMBASE, SCOPUS, and Web of Science databases since inception to May 1, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. After duplicate records removed, the search strategy retrieved 103 articles. The full texts of 73 articles further were assessed for eligibility, and 44 studies were finally included in the systematic review. The mainstay surgical treatment of OHVIRA syndrome is usually a minimally invasive vaginal approach to remove the septum. Ultrasound-guided hysteroscopic resection and laparoscopic resection of the septum have been described as alternatives. Considering the feasibility of minimally invasive approach for the management of the syndrome, laparotomy should be avoided as much as possible and considered only in selected cases.

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Section: Discussionmentioning

confidence: 99%

Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: A Systematic Review about Diagnosis and Surgical Management

Moufawad,

Giannini,

D’Oria

et al. 2023

Gynecology and Minimally Invasive Therapy

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“…A bicornuate uterus is caused by incomplete fusion of the Müllerian ducts [ 7 ]. With the advent of new investigation techniques like MRI and 2D ultrasonography, it is much more feasible to diagnose a malformed uterus.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of a Normal Pregnancy in a Bicornuate Uterus Through In Vitro Fertilization

Agarwal¹,

Tayade²,

Sharma³

2022

Cureus

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The case report has been done to examine the possibility of normal pregnancy achieved in the case of a rare congenital anomaly, the bicornuate uterus. A bicornuate uterus is a very rare congenital anomaly of the uterus, which falls in the class 4 category according to the classification of Mullerian duct anomalies given by the American Society of Reproductive Medicine and is associated with several obstetrics complications like malpresentation, recurrent abortions, and growth restrictions. However, to have a normal pregnancy in a bicornuate uterus, close antenatal monitoring is required, and, depending on the individual, surgical unification can be done. A 30-year-old woman with G3A2 with 34.3 weeks of gestational age with in vitro fertilization (IVF) conception came with cervical stitch in situ and oligohydramnios with liquor index 7 for safe confinement. At the time of admission, amenorrhea was present for nine months. Ultrasound at 33 weeks three days showed a single uterine live fetus weighing about 2187 grams. The interpretation of the color Doppler was also normal. Fetal heart sound was heard in the Doppler. She was operated on at 36 weeks as an emergency lower-section cesarean section procedure. The indication was that it was an IVF baby, and the female had presented with oligohydramnios on performing investigations. The patient was counseled accordingly and discharged on 22 February 2022. She was advised to come back after 15 days or SOS at the time of emergency. All the measures were suggested, including adequate rest, plenty of fluids, and a good protein diet. Most cases of the bicornuate uterus do not present with any symptoms, i.e., they are asymptomatic and can be detected during routine evaluation of the patient. However, some patients can also have symptoms like menstrual problems such as dysmenorrhea and menorrhagia. Also, along with this anomaly, associated anomalies may be present, including agenesis of the kidney and ureter. The first and foremost investigation to be done is ultrasonography, which tells about the diagnosis of the bicornuate uterus. Magnetic resonance imaging is the gold standard test for its diagnosis. However, the diagnosis in the case of asymptomatic patients is relatively tricky and requires aggressive prenatal monitoring and needs to be kept in observation to make the pregnancy successful.

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“…In 1907, Paul Strassman first described the surgical correction of the double uterus; since then, the Strassman metroplasty has stood out as the standard procedure for the correction of the bicornuate uterus, showing a success rate for conception, reaching term gestation of up to 70-80% after the procedure; in addition to the improvement of the painful symptoms referred by the patients 9 , for which continuing to innovate in less radical procedures can be the future advance in the area of microsurgery in Gynecology.…”

Section: Discussionmentioning

confidence: 99%

“…En 1907, Paul Strassman describió por primera vez la corrección quirúrgica del doble útero; desde entonces, la metroplastia de Strassman se ha destacado como el procedimiento estándar para la corrección del útero bicorne, mostrando buena tasa de éxito para la concepción, alcanzando una gestación a término de hasta un 70-80% después del procedimiento; además de la mejoría de los síntomas dolorosos referidos por los pacientes 9 , por lo que continuar innovando en procedimientos menos radicales puede ser el avance futuro en el área de la microcirugía en Ginecología.…”

Section: Discussionunclassified

Microsurgical technique for reconstruction of Hemi-uterus with non-communicating rudimentary uterine horns

2022

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Case description: Three patients diagnosed with Hemi-uterus with non-communicating functional rudimentary cavity are reported. Clinical findings: Adolescent patients with disabling pelvic pain during menstrual periods, depressive states, and functional disability secondary to pain. Treatment and outcome: Reconstruction of Hemi-uterus with non-communicating functional rudimentary cavity using a microsurgical technique, without the need for non-communicating horn resection. The patients were assessed at the 1st, third, and sixth months, showing a marked improvement in their dysmenorrhea. In addition, there was an improvement in the depressive state; there was no change in the volume of her menstrual bleeding, and one of these patients achieved pregnancy with normal prenatal control and cesarean delivery, obtaining a full-term newborn without complications. Clinical Relevance: Description of a novel microsurgical technique for the management of the hemi-uterus with a non-communicating functional rudimentary cavity, which could benefit not only the reduction of associated symptoms but could also become an alternative to improve fertility.

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Successful Pregnancy Outcome after Open Strassman Metroplasty for Bicornuate Uterus

Cited by 6 publications

References 7 publications

Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: A Systematic Review about Diagnosis and Surgical Management

Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: A Systematic Review about Diagnosis and Surgical Management

A Case Report of a Normal Pregnancy in a Bicornuate Uterus Through In Vitro Fertilization

Microsurgical technique for reconstruction of Hemi-uterus with non-communicating rudimentary uterine horns

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