Management and reproductive outcome of complete septate uterus with duplicated cervix and vaginal septum: review of 21 cases
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
To evaluate the reproductive outcomes of complete septate uterus with duplicated cervix and vaginal septum.
Twenty-one patients who have complete septate uterus with duplicated cervix and vaginal septum were retrospectively reviewed in this study. In Group I, 11 patients with a poor reproductive outcome (spontaneous miscarriage or infertility) or dyspareunia underwent hysteroscopic metroplasty and removal of vaginal septum with the preservation of cervical septum. In Group II, 10 patients without a history of spontaneous miscarriage did not undergo hysteroscopic transection of the uterine septum. Of 10, four underwent vaginal septum incision due to dyspareunia, two underwent mere laparoscopic pelvic adhesiolysis because of infertility, and four without symptoms had no intervention. The primary endpoints included the pregnancy rate and outcomes of pregnancies.
In Group I, the pregnancy rate after surgery is 81.8 % (9/11). Of nine women who conceived, six had term delivery, one encountered induced abortion due to the malformation of the fetal heart, and two had ongoing pregnancy. In Group II, among six patients accepting surgery, three had term delivery. The pregnancy rate after operation is 50 % (3/6).
The uterine septum may not necessarily be transected for patients who have complete septate uterus with duplicated cervix and vaginal septum, and meanwhile have no a history of poor reproductive outcome.
- Ashton D, Amin HK, Richart RM, Neuwirth RS (1988) The incidence of asymptomatic uterine anomalies in women undergoing transcervical tubal sterilization. Obstet Gynecol 72(1):28–30
- Acien P, Acien M (2004) Evidence-based management of recurrent miscarriage. Surgical management. Int Congr Series 1(266):335–342 CrossRef
- Fedele L, Bianchi S (1995) Hysteroscopic metroplasty for septate uterus. Obstet Gynecol Clin North Am 22(3):473–489
- Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simon C, Pellicer A (1997) Reproductive impact of congenital mullerian anomalies. Hum Reprod 12(10):2277–2281 CrossRef
- Homer HA, Li TC, Cooke ID (2000) The septate uterus: a review of management and reproductive outcome. Fertil Steril 73(1):1–14 CrossRef
- Wang JH, Xu KH, Lin J, Chen XZ (2009) Hyseroscopic septum resection of complete septate uterus cercical duplication, sparing the double cervix in patients with recurrent spontaneous abortions or infertility. Fertil Steril 91(6):2643–2649 CrossRef
- Oppelt P, Renner SP, Brucker S, Strissel PL, Strick R, Oppelt PG, Doerr HG, Schott GE, Hucke J, Wallwiener D, Beckmann MW (2005) The VCUAM (vagina cervix uterus adnex-associated malformation) classification: a new classification for genital malformations. Fertil Steril 84(5):1493–1497 CrossRef
- Oppelt P, von Have M, Paulsen M, Strisel PL, Strick R, Brucker S, Wallwiener D, Beckmann MW (2007) Female genital malformations and their associated abnormalities. Fertil Steril 87(2):335–342 CrossRef
- Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P (2001) Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update 7(2):161–174 CrossRef
- Fedele L, Dorta M, Brioschi D, Giudici MN, Candiani GB (1989) Pregnancies in septate uteri: outcome in relation to site of uterine implantation as determined by sonography. AJR Am J Roentgenol 152(4):781–784 CrossRef
- Rock JA, Murphy AA (1986) Anatomic abnormalities. Clin Obstet Gynecol 29(4):886–911 CrossRef
- Fedele L, Bianchi S, Marchini M, Franchi D, Tozzi L, Dorta M (1996) Ultrastructural aspects of endometrium in infertile women with septate uterus. Fertil Steril 65(4):750–752
- Heinonen PK (2006) Complete septate uterus with longitudinal vaginal septum. Fertil Steril 85(3):700–705 CrossRef
- Siegler AM, Valle RF (1988) Therapeutic hysteroscopic procedures. Fertil Steril 50(5):685–701
- Parsanezhad ME, Alborzi S, Zarei A, Dehbashi S, Shirazi LG, Rajaeefard A, Schmidt EH (2006) Hysteroscopic metroplasty of the complete uterine septum, duplicate cervix, and vaginal septum. Fertil Steril 85(5):1473–1477 CrossRef
- Valle RF (1996) Hysteroscopic treatment of partial and complete uterine septum. Int J Fertil Menopausal Stud 41(3):310–315
- Israel R, March CM (1984) Hysteroscopic incision of the septate uterus. Am J Obstet Gynecol 149(1):66–73
- Fedele L, Arcaini L, Parazzini F, Vercellini P, Di Nola G (1993) Reproductive prognosis after hysteroscopic metroplasty in 102 women: life-table analysis. Fertil Steril 59(4):768–772
- Management and reproductive outcome of complete septate uterus with duplicated cervix and vaginal septum: review of 21 cases
Archives of Gynecology and Obstetrics
Volume 287, Issue 4 , pp 709-714
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Complete septate uterus
- Hysteroscopic metroplasty
- Reproductive outcome
- Industry Sectors
- Author Affiliations
- 1. Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, 58# Zhong Shan Road II, Guangzhou, 510080, People’s Republic of China
- 2. Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China