Pregnancy and Adverse Obstetric Outcomes After Hysteroscopic Resection: A Systematic Review and Meta-Analysis

Frontiers in Surgery

article

Xue Wu¹  Mei Zhang³  Ping Sun¹  Jing-jing Jiang¹  Lei Yan¹ 

[1] School of Medicine, Cheeloo College of Medicine, Shandong University;Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University;Qufu Maternity and Infant health Hospital;National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University;Key laboratory of Reproductive Endocrinology, Ministry of Education, Shandong University;Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University

关键词: septate uterus;    hysteroscopic resection;    septum resection;    pregnancy outcomes;    live birth rate;    term delivery;    adverse obstetric outcomes;   

DOI  :  10.3389/fsurg.2022.889696

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective Although the randomized controlled trial (RCT) of the efficacy of hysteroscopic resection in women with uterine septum has not shown any significant correlation in recent research, motivation for deeper study remains insufficient. In this study, the objective was to determine pregnancy-related outcomes, along with adverse obstetric outcomes, following hysteroscopic resection and also to determine whether women with hysteroscopic resection bear the same outcomes as women with normal uterine cavities. Search Methods From January 1995 to February 2022, a systematic literature review was conducted to identify all studies published concerning the gestation outcomes of women with and without hysteroscopic resection while comparing the gestation outcomes of women after hysteroscopic resection and with a normal uterine cavity. Our primary outcome was the live birth rate (LBR). The secondary outcomes were term delivery, preterm delivery, spontaneous miscarriage, malpresentation, cesarean section, and other adverse obstetric outcomes. Results 22 studies were included in this meta-analysis. The control groups of 14 studies were treated women, and the control groups of the other 8 studies were patients bearing a normal uterine cavity. Hysteroscopic resection was related to a higher rate of term delivery (OR = 2.26, 95% CI, 1.26–4.05), and a lower rate of spontaneous abortion (OR = 0.50, 95% CI, 0.27–0.93), and a lower rate of malpresentation (OR = 0.31, 95% CI, 0.19–0.50). Nevertheless, in comparison with the normal uterus group, the rates of preterm birth, cesarean section, and postpartum hemorrhage after resection did not return to normal levels. Conclusion Hysteroscopic resection can effectively reduce the risk of abortion and malpresentation in patients possessing a uterine septum while increasing the term delivery rate. Although well-designed RCTs should confirm our meta-analysis, it still bears recommending to patients.

【 授权许可】

CC BY