scholarly journals Hysteroscopy in Uterine Anomalies: A Boon!

2016 ◽  
Vol 8 (1) ◽  
pp. 74-76
Author(s):  
Rahul Manchanda ◽  
Charu Pathak
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Case Series ◽  
Uterine Cavity ◽  
High Rate ◽  
Invasive Technique ◽  
Reproductive Outcome ◽  
Septate Uterus ◽  
Fetal Survival ◽  
Uterine Anomalies

ABSTRACT Introduction The incidence of congenital uterine malformations is as high as 3 to 4% with septate uterus being one of the most common forms of congenital malformation. Structurally anomalous uterus has been recognized as a cause of infertility, and obstetric complications. Of all known uterine anomalies, septate uterus is the most common and is associated with poorest reproductive outcome, with fetal survival rates between 6 to 28%. Also, it carries high rate of spontaneous miscarriage exceeding > 60% but, on the bright side, it is one of the uterine anomaly that is most amenable via simple hysteroscopic management. Aims and objectives To describe a case series (comprising two cases) septate uterus managed successfully using hysteroscopy. Background Septate uterus results from incomplete resorption of paramesonephric mullerian ducts during the first trimester of pregnancy. Depending on the size of septum, it can be incomplete septum or complete septum dividing the uterine cavity into two separate components including two cervix and vaginal septum. Congenital malformations may be associated with recurrent pregnancy loss, preterm labor, abnormal fetal presentation, intrauterine growth restriction (IUGR) and infertility. Hysteroscopy is considered the gold standard for the assessment and treatment of intrauterine anomalies. Cases Authors report two cases of septate uterus managed hysteroscopically. • A case of complete septate uterus and another case of complete septate uterus with two cervices, managed hysteroscopically both subjects conceived successfully after treatment. Conclusion Operative hysteroscopy is an effective and safe minimally invasive technique to manage complete uterine septum, associated with quicker recovery. Additionally, there is no scar formation which promotes improved reproductive outcome. It has enabled more liberalized approach to treatment, i.e. now being extended to include patients with recurrent pregnancy loss and premature labor. Also, this intervention can be used successfully in patients diagnosed with infertility secondary to uterine septations, especially if in vitro fertilization (IVF) is being contemplated. How to cite this article Pathak C, Manchanda R, Yadav G. Hysteroscopy in Uterine Anomalies: A Boon! J South Asian Feder Obst Gynae 2016;8(1):74-76.

scholarly journals A méhüreg anatómiai rendellenességei habituális vetélőkben

2015 ◽  
Vol 156 (27) ◽  
pp. 1081-1084 ◽  
Author(s):  
Ádám Galamb ◽  
Boglárka Pethő ◽  
Dávid Fekete ◽  
Győző Petrányi ◽  
Attila Pajor
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Uterine Cavity ◽  
Endometrial Polyp ◽  
3 Dimensional ◽  
Uterine Anomalies ◽  
Uterine Septum

Introduction: One percent of couples trying to have children are affected by recurrent miscarriage. These pregnancy losses have different pathogenetic (genetic, endocrine, anatomic, immunologic, microbiologic, haematologic and andrologic) backgrounds, but recurrent miscarriage remains unexplained in more than half of the affected couples. Aim: To explore risk factors for recurrent pregnancy loss the authors studied the incidence of anatomic disorders of the uterine cavity occur in Hungarian women with recurrent miscarriage. Method: Medical records of 152 patients with recurrent miscarriage were analyzed retrospectively. In order to explore disorders of the uterine cavity hysteroscopy or 3-dimensional sonography in 132 women, hysterosalpingography in 16 and hysterosalpingo-sonography in 4 patients were used. Results: Incidence of anomalies in the uterine cavity was found in women with recurrent miscarriage to be 15.8%. A variety of the uterine anomalies was found including uterine septum in 6.5%, endometrial polyp in 2.6%, arcuate and bicornuate uteri both in 2% and 2%, submucosal myoma in 1.3 %, and intrauterine synechiae in 1.3%. Conclusions: These findings suggest that morphologic disorder of the uterine cavity is frequent in Hungarian women with recurrent miscarriage. Therefore, assessment of the uterine anatomy is recommended in such patients. Orv. Hetil., 2015, 156(27), 1081–1084.

scholarly journals Reproductive Outcome after Hysteroscopic Metroplasty in Patients with Infertility and Recurrent Pregnancy Loss

2014 ◽  
Vol 2 (1) ◽  
pp. 103-108 ◽  
Author(s):  
Gligor Tofoski ◽  
Jadranka Georgievska
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Fetal Loss ◽  
Live Birth Rate ◽  
Abortion Rate ◽  
Control Group ◽  
Reproductive Outcome ◽  
Chi Square ◽  
Uterine Anomalies ◽  
Before And After

Introduction: Reproductive outcome can be negatively affected in patients with congenital uterine anomalies (CUA), increasing the number of unsuccessful pregnancies and obstetric complications. Compared with the population with normally formed uterus, patients with CUA have higher abortion rate, higher fetal loss rate and decreased live birth rate. Hysteroscopic metroplasty (HM) is a standard, safe and minimally invasive method for the treatment of correctible types of congenital uterine anomalies.Aim: The aim of the study was to analyze the reproductive outcome in group of patients with infertility and recurrent pregnancy loss and present CUA, before and after hysteroscopic metroplasty.Material and Methods: We analyzed 67 patients to whom 78 interventions hysteroscopic metroplasty were performed at the University Clinic of Obstetrics and Gynecology in Skopje during a two year period, between 01.01.2010 and 31.12.2011. Their reproductive outcome was monitored during a two-year period and the same group served as a control group, taking into account their previous reproductive history. Statistical analysis was performed using Chi-square test and p < 0.05 was considered to be statistically significant.Results: Most common CUA were types 5b and 6 represented by 88 %. In a follow up period of two years, 33 of the patients become pregnant. There was a statistically significant decrease of abortion rate from 92% to 21.2%, as well as an increase in the term delivery rate from 0% to 69.7%.Conclusion: Treatment with hysteroscopic metroplasty is significantly improving the reproductive outcome in patients with CUA and previous fetal loss.

scholarly journals Detection of plasminogen activator inhibitor-1 (-675 4G/5G) gene polymorphism in women with recurrent abortion

2019 ◽  
Vol 7 (2) ◽  
pp. 41-44
Author(s):  
Iglal Youssef Shaala ◽  
Akram Abdel Moneim Deghady ◽  
 Reham Abdel Haleem Abo Elwafa ◽  
Tamer Ahmed Hosny ◽  
Engy Taher Ammar
Keyword(s):  
Gene Polymorphism ◽  
Plasminogen Activator ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Plasminogen Activator Inhibitor ◽  
Recurrent Abortion ◽  
Plasminogen Activator Inhibitor 1 ◽  
Uterine Anomalies ◽  
Activator Inhibitor ◽  
Pai 1

Background: recurrent abortion is considered one of the most common complications that occur during pregnancy and counts for 15% of pregnancies that are recognized clinically. Many causes can be attributed to the recurrent pregnancy loss e.g. chromosomal anomalies, thrombophilic disorders, uterine anomalies, endocrine abnormalities and fetal anomalies. Thrombophilia can be either hereditary or acquired. Multiple genes had been implicated in the pathogenesis of the thrombophilia. Previous studies have indicated that genetic polymorphism of the plasminogen activator inhibitor-1 gene (PAI-1) may be associated with recurrent abortion. Aim: The aim of the present study was to investigate whether plasminogen activator inhibitor-1 (-675 4G/5G) gene polymorphism is associated with the occurrence of recurrent pregnancy loss or not. Methods: DNA samples were collected from sixty six female patients with recurrent abortion (33 primary abortion, 33 secondary abortion) and thirty four healthy controls with normal pregnancy for detection of plasminogen activator inhibitor-1 (-675 4G/5G) gene polymorphism by restriction fragment length polymorphism PCR. Results: there was a significant association between PAI-1(-675 4G/5G) polymorphism and the occurrence of recurrent pregnancy loss. Conclusion: Our results assumed that PAI-1 (-675 4G/5G) polymorphism is associated with recurrent pregnancy loss.

scholarly journals Influence of Hysteroscopic Metroplasty on Reproductive Outcome in Patients with Infertility and Recurrent Pregnancy Loss

PRILOZI ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 95-103
Author(s):  
Gligor Tofoski ◽  
Vesna Antovska
Keyword(s):  
Reproductive Potential ◽  
Uterine Cavity ◽  
Live Birth Rate ◽  
Abortion Rate ◽  
Control Group ◽  
Reproductive Outcome ◽  
Chi Square ◽  
Foetal Loss ◽  
Uterine Anomalies ◽  
Before And After

Abstract Introduction: Patients with congenital uterine anomalies (CUA) have decreased reproductive potential and an unfavourable reproductive outcome compared to the population with normal uterine cavity. Patients with untreated CUA have a higher abortion rate, higher foetal loss rate and decreased live birth rate. Hysteroscopic metroplasty is a standard, safe and minimally invasive method for the treatment of correctible types of congenital uterine anomalies. The aim of the study was to analyse the reproductive outcome in certain groups of patients with CUA and infertility, before and after hysteroscopic metroplasty. Material and methods: We analyzed 115 patients on whom 129 hysteroscopic metroplasty interventions were performed at the University Clinic of Obstetrics and Gynaecology in Skopje over a one-year period, between 01.01.2011 and 31.12.2011. Patients and their reproductive outcome were monitored over a two-year period and the same group served as a control group, taking into account their previous reproductive history before and after metroplasty. Statistical analysis was performed using the Chi-square test and p < 0.05 was considered to be statistically significant. Results: The most common CUA were types 5b and 6, represented by 83.3%. In a follow-up period of two years, there were 55 patients with previous foetal loss treated by hysteroscopic metroplasty, and 31 of them had pregnancies. There was a statistically significant decrease of abortion rate from 88.5% to 19.3%, and a significant increase in term delivery rate from 2.3% to 71%. Conclusion: Hysteroscopic metroplasty significantly improves the reproductive outcome in patients with previous foetal loss.

Hysteroscopy in the Evaluation of Recurrent First Trimesteric Miscarriages

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A I Abdelmageed ◽  
M M Alsherbiny ◽  
A M Abdelhamed ◽  
W Y Alsaleem
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Treatment Strategies ◽  
Uterine Cavity ◽  
First Trimester ◽  
Maternity Hospital ◽  
Uterine Septum ◽  
Study Population ◽  
Diagnostic Hysteroscopy

Abstract Background Recurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown and there are few evidence-based diagnostic and treatment strategies. Studies on the etiology, evaluation, and management of RPL are often flawed, uterine factors (acquired and congenital)are responsible for 10 to 50 %of recurrent pregnancy loss,hysteroscopy is the gold standard for evaluation of the eendometrial cavity. Aim of the work to evaluate the role of hysteroscopy in the diagnosis of possible uteri.ne congenital and acquired causes of recurrent first trimesteric miscarriages. Patients and methods This prospective cohort study was conducted on 164 patients with recurrent (3 or more), first trimester miscarriage planned to undergo office (diagnostic) hysteroscopy to assess the uterine cavity, who attend Ain Shams University maternity Hospital Early Cancer detection Unit during period from July 2018 to December 2018. Results the largest proportion 53% of our study population had abnormal hysteroscopic findings, and the uterine septum had the highest prevalence among women with recurrent first trimesteric miscarriages. Conclusion In women with recurrent pregnancy loss, hysteroscopy is a useful diagnostic tool in the diagnosis of possible uterine causes of recurrent miscarriages. Uterine septum is the most common congenital uterine abnormality found in patients with recurrent first trimesteric miscarriages.

scholarly journals Comparison of empirical use of low dose aspirin and enoxaprin in the treatment of unexplained recurrent pregnancy loss

2020 ◽  
Vol 9 (3) ◽  
pp. 1138
Author(s):  
Sunil Kumar Juneja ◽  
Pooja Tandon ◽  
Gagandeep Kaur ◽  
Bakul Kapoor ◽  
Guneet Singh Sidhu
Keyword(s):  
Live Birth ◽  
Pregnancy Loss ◽  
Low Dose ◽  
Recurrent Pregnancy Loss ◽  
Chromosomal Anomalies ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Uterine Anomalies ◽  
Significant Difference ◽  
Recurrent Pregnancy Losses

Background: Recurrent pregnancy losses have commonly been defined as three or more consecutive spontaneous pregnancy losses. About 1-2% of women suffer from recurrent miscarriages. The cause is multifactorial such as uterine anomalies, endocrine disorders, immunological causes, infections, chromosomal anomalies and maternal autoimmune diseases. In 50-60% of cases recurrent pregnancy losses, the cause remains unclear. Objective of this study was to compare the maternal and fetal outcome in patients with unexplained recurrent pregnancy loss treated with LMWH (Enoxaparin) vs Aspirin during pregnancy.Methods: Women with 3 or more pregnancy losses, aged between 18-40 years, booked for antenatal care and delivery in our hospital between January 2012 and December 2016 were followed till 6 months after delivery.Results: A total number of 146 women were assessed for eligibility. We had 62 women in Group A (aspirin group) and 84 women in Group E (enoxaparin group). Enoxaparin was given to all those ladies who had taken aspirin in previous pregnancies with no live outcome. Good neonatal outcome was observed with Enoxaparin.Conclusions: Live birth rates did not show significant difference between the two study groups. But empirical use of enoxaparin in patients with no live birth who have taken low dose aspirin in previous pregnancy had shown improved results, so enoxaparin should be used empirically as a first line agent in such cases.

Uterine Anomalies and Recurrent Pregnancy Loss

2020 ◽  
pp. 110-125
Author(s):  
Daniel S. Seidman ◽  
Mordechai Goldenberg
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Uterine Anomalies
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