Reproductive performance after selective metroplasty

Abstract AR

Objectives : To evaluate the influence of selective metroplasty on reproductive performance of uterine fusional anomalies.

Methods: This was a prospective study conducted at Baghdad University Hospital.

There were 82 patients with congenital uterine fusional anomalies causing reproductive wastage.

They were divided into 2 groups.

Group I (n=75) had a total of 270 pregnancies and only 2 viable infants.

Group II (n—7) had primary infertility.

Hysterosalpingographies and diagnostic laparoscopies were done for all.

Based on cavity shape/septal width and depth criteria, selection of the appropriate metroplastic procedure was made from the conventional and modified pool of option: Tompkin, modified Tompkin, Strassmann, Baghdad, and Jones procedures.

The main outcome measure was fetal survival rate.

Results : Group I: 63 patients carried term pregnancies, 39 after Baghdad, 9 after Jones, 6 after Strassmann, 5 after Tompkin, and 4 after modified Tompkin.

Five continued to abort, 2 after Jones, 1 after Tompkin, 1 after modified Tompkin, and 1 after Strassmann procedure.

Seven failed to conceive, 5 after Baghdad, 1 after Tompkin, and 1 after Strassmann procedure.

Group II: five patients delivered term babies, 3 after Baghdad, 1 after Jones ind 1 after modified Tompkin procedure.

Two failed to concieve, 1 after Baghdad and 1 after Tompkin procedure.

The overall fetal survival rate increased from 0.74% before metroplasty to 92.94% after selective repairs.

Conclusion: Selective metroplasty improves reproductive performance of congenital uterine fusional anomalies.