ORİJİNAL ARAŞTIRMALAR
Uterin Septumlu Olgularda Histeroskopik Septum İnsizyonu Sonrası Gebelik Sonuçları
Pregnancy Results Following Hysteroscopic Septum Incision in Cases with Uterine Septum
Received Date : 08 Dec 2020
Accepted Date : 13 Jan 2021
Available Online : 03 Feb 2021
Aslı ALTINORDU ATÇIa, Selim MISIRLIOĞLUa, Levent TOKSÖZa
aÇukurova Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum ABD, Adana, TÜRKİYE
Doi: 10.24074/tjrms.2020-80478 - Makale Dili: TR
TJRMS. 2020;4(2):53-8
ÖZET
Amaç: Bu çalışmanın amacı, tekrarlayan gebelik kaybı öyküsü olan veya primer infertilite tanısı ile başvuran ve eş zamanlı uterin septum tespit
edilen olgularda histeroskopik septum insizyonu sonrası gebelik sonuçlarının retrospektif olarak incelenmesidir. Gereç ve Yöntemler: Çukurova
Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği İnfertilite Polikliniğine primer infertilite veya tekrarlayan gebelik kaybı nedeniyle
başvuran ve histerosalpingografide uterin septum tespit edilen 76 hasta çalışmaya dahil edildi. 27 hasta primer infertil, 49 hasta tekrarlayan
gebelik kaybı öyküsü olan grupta idi. Tüm olgulara genel anestezi altında laparoskopi eşliğinde histeroskopik septum insizyonu operasyonu uygulandı.
Postoperatif takip süresi 18 ± 8 ay olarak alındı. Her iki grup operasyon öncesi ve sonrası toplam gebelik sayısı, toplam abortus ile preterm
ve term doğum sayısı, kümülatif canlı doğum oranları, doğum şekilleri, kontrol HSG’leri ve reopere olabilme olasılıkları açısından
karşılaştırıldı. Bulgular: Elli-beş (% 72,4) hastanın komplet, 21 (% 27,6) hastanın inkomplet septumu mevcuttu. Operasyon sonrası 76 hastanın
55 (% 72,4)’i gebe kaldı, toplam gebelik sayısı 79 idi. Bunun 14 (% 17,8)’ü spontan abortus, 12 (% 15,2)’si preterm doğum, 53 (% 67)’ü term
doğum olarak tespit edildi. Operasyon öncesi % 3,4 olan kümülatif canlı doğum oranının operasyon sonrası % 70’ e yükseldiği saptandı. Sonuç:
Uterin septumların histeroskopik insizyonu kolay uygulanabilir ve etkin bir yöntemdir. Özellikle tekrarlayan gebelik kaybı öyküsü olan hastalarda
operasyonun başarısı primer infertil olan hastalara göre daha fazladır.
Anahtar Kelimeler: Mülleryan anomali; uterin septum; histeroskopi; metroplasti; gebelik
ABSTRACT
Objective: The aim of this study is to retrospectively examine the pregnancy outcomes after hysteroscopic septum incision in cases with a history
of recurrent pregnancy loss or a diagnosis of primary infertility and in whom uterine septum is detected. Material and Methods: Seventysix
patients who were admitted to the Infertility Outpatient Clinic of Çukurova University Faculty of Medicine due to primary infertility or
recurrent pregnancy loss and who had uterine septum detected in hysterosalphingography were included in the study. 27 patients were in the primary
infertile group, 49 patients were in the group with a history of recurrent pregnancy loss. A laparoscopy-guided hysteroscopic septum incision
was performed under general anesthesia. Postoperative follow-up period was taken as 18 ± 8 months. Both groups were compared in terms
of pre- and postoperative total pregnancy numbers, total abortus, preterm, term births, cumulative live birth rates, delivery types, control HSGs
and their reoperation. Results: Fifty-five (72.4%) patients had complete septum and 21 (27.6%) patients had incomplete septum. 55 (72.4%) of
76 patients became pregnant after the operation, the total number of pregnancies was 79. Of these, 14 (17.8%) were found as spontaneous abortion,
12 (15.2%) as preterm delivery, and 53 (67%) as term delivery. The cumulative live birth rate, which was 3.4% before the operation, increased
to 70% after the operation. Conclusion: Hysteroscopic incision of the uterine septum is an easy and effective method. Especially in patients with
a history of recurrent pregnancy loss, the success of the operation is higher than in patients with primary infertility.
Keywords: Mullerian anomalies; uterine septum; hysteroscopy; metroplasty; pregnancy
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