Is hysteroscopic metroplasty using the incision method for septate uterus a risk factor for adverse obstetric outcomes?
Is hysteroscopic metroplasty using the incision method for septate uterus a risk factor for adverse obstetric outcomes?
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DOI：
10.1111/jog.13884
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发表时间：
2019-03-01
影响因子：
1.6
通讯作者：
Takeshita, Toshiyuki
中科院分区：
文献类型：
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作者：
Ono, Shuichi;Kuwabara, Yoshimitsu;Takeshita, Toshiyuki
目的 本研究旨在评估纵隔子宫切口法宫腔镜子宫成形术是否是妊娠或分娩期间不良产科结局的危险因素。方法 这项回顾性、单中心产科并发症队列研究纳入了 41 例复发性流产或不明原因不孕患者，采用宫腔镜纵隔子宫切开法子宫成形术。作为对照，我们招募了 1139 名同期在我们医院分娩的女性。主要结局指标包括平均分娩周数、平均出生体重、剖宫产率、臀位率、产后出血率、早产率、胎盘早剥率、前置胎盘率、植入性胎盘率以及妊娠和分娩期间子宫破裂率。结果两组在年龄、平均分娩周数、平均出生体重、产后出血率、早产率、胎盘早剥率、前置胎盘率、植入性胎盘率等方面无差异。研究组的剖宫产率和臀位率显着高于对照组（分别为 56.1% vs 27.7%；P = 0.0002 和 19.5% vs 6.8%；P = 0.007）。宫腔镜子宫成形术后怀孕或分娩期间没有发生子宫破裂的病例。结论 宫腔镜下纵隔子宫切开法子宫成形术不是不良产科结局的危险因素。术后活产组未出现胎盘早剥、前置胎盘、植入性胎盘、子宫破裂、大出血等严重并发症。
Aim This study aimed to assess whether hysteroscopic metroplasty using the incision method for septate uterus is a risk factor for adverse obstetric outcomes during pregnancy or delivery. Methods This retrospective, single-center cohort study of obstetric complications included 41 patients with recurrent pregnancy loss or unexplained infertility who underwent hysteroscopic metroplasty using the incision method for septate uterus. As controls, we recruited 1139 women who delivered at our hospital during the same period. The primary outcomes were mean weeks of delivery, mean birthweight, rate of cesarean section, rate of breech presentation, rate of post-partum hemorrhage, rate of preterm delivery, rate of placental abruption, rate of placenta previa, rate of placenta accreta and uterine rupture during pregnancy and delivery. Results The two groups did not differ in terms of age, mean weeks of delivery, mean birthweight, rate of post-partum hemorrhage, rate of preterm delivery, rate of placental abruption, rate of placenta previa or rate of placenta accreta. The rates of cesarean section and breech presentation were significantly higher in the study group than in the control group (56.1 vs 27.7%; P = 0.0002 and 19.5 vs 6.8%; P = 0.007, respectively). There were no cases of uterine rupture during pregnancy or delivery following hysteroscopic metroplasty. Conclusion Hysteroscopic metroplasty using the incision method for septate uterus is not a risk factor for adverse obstetric outcomes. No severe complications, such as placenta abruption, placenta previa, placenta accreta, uterine rupture or heavy hemorrhage, were observed in the postoperative live birth group.