Efficacy of using the modified hysteroscopic metroplasty method in women with a history of uterine septum and RPL-syndrome

Abstract

The aim: to improve the results of treatment of women with RPL- syndrome associated with uterine septum (US) by modifying the technique of hysteroscopic metroplasty (HM). Materials and methods. The study involved 138 patients with uterine septum and RPL - syndrome in the anamnesis who were operated on between 2018 and 2023. The main group (I clinical) consisted of 88 patients in whom hysteroscopic metroplasty was performed according to the proposed modified technique. The comparative group (II clinical) consisted of 50 patients who were operated on according to the classical method of HM. The age of patients in both groups ranged from 19 to 40 years. The effectiveness of operations was assessed by questioning during consultations or by questionnaire data on pregnancy onset and its completion during the first year after HM. The formation of postoperative intrauterine adhesions (IUA) was also evaluated according to second-look hysteroscopy data in 3–6 months after HM in some patients. Statistical analysis of the results obtained was carried out using the program "Primer Biostatistics" (USA). The results. The proposed modified HM technique helps reduce the frequency of postoperative synechiae and severe forms of IUA after the procedure (p<0.05). In the main group, compared to the second group, the frequency of spontaneous miscarriages decreased by 3 times, the frequency of spontaneous pregnancies increased by 20%, and the total frequency of pregnancies and live births increased (p<0.05). Conclusions. The results obtained in the study indicate the expediency of implementation and use of the modified HM method.