Adverse obstetric outcomes at term after hysteroscopic metroplasty

Abstract

Study objective: To estimate obstetrical complications at term after hysteroscopic metroplasty for septate uterus.

Design: A retrospective comparative study (Canadian Task Force classification II-2).

Setting: La Conception Hospital, Department of Obstetrics and Gynecology, Marseille, France.

Patients and interventions: Thirty-one women who had a term pregnancy from January 1996 through December 2004 after hysteroscopic metroplasty for septate uterus (group A) were studied retrospectively. A control group (group B) of 62 women was selected from the same database who had term pregnancies and no history of hysteroscopic metroplasty.

Measurements and main results: Obstetric complications at term and neonatal outcomes after hysteroscopic metroplasty were compared between 2 groups. The rate of fetal malpresentation was significantly higher in group A versus group B (11/31 [35.5%] vs 0/62, p < .001). Mean birth weight was significantly lower in group A versus group B (2940 g +/- 52 vs 3266 g +/- 456, p =.002). The rate of caesarean section was significantly higher in group A versus group B (19/31 [61.3%] vs 4/62 [6.4%], p < .001).

Conclusion: The results of this study suggest that patients with a previous hysteroscopic metroplasty for septate uterus are at increased risk for fetal malpresentation at term, low birth weight infants, and delivery by caesarean section and should therefore be informed of these risks before delivery.