Laparoscopic metroplasty in bicornuate and didelphic uteri: feasibility and outcome.
OBJECTIVE
To report the outcomes of laparoscopic metroplasty in bicornuate and didelphic uteri.


METHODS
This observational study includes 26 women with double uterine cavities (22 bicornuate and 4 didelphic uteri) with history of recurrent pregnancy loss undergoing laparoscopic metroplasty, second-look laparoscopy and hysteroscopy between 2008 and 2013 in University and Private hospital (Shiraz, Iran). The feasibility of laparoscopic metroplasty, appropriateness of the uterine cavity upon second-look laparoscopy, pregnancy outcome and live birth rate (within at least 12 month follow-up) were evaluated.


RESULTS
All patients had a unified and acceptable uterine cavity in second-look operation. Minimal pelvic adhesions in eight cases and subseptum of uterus in seven patients were detected which were removed by laparoscopy and resectoscopy, respectively. Out of 14 patients who could be followed for one year for pregnancy occurrence 12 patients had conception. Out of them nine term pregnancies with normal pregnancy and delivery outcomes were reported. These women delivered nine live neonates through the cesarean section. Three patients had pregnancy loss (2 early pregnancy losses and one with preterm delivery). Two patients decided to postpone conception due to personal reasons.


CONCLUSIONS
Laparoscopic metroplasty by developing single uterine cavity with a suitable volume and minimal adhesion formation can be a substitute for laparotomy technique. However, more long-term studies should be done on larger sample size to confirm its positive effects on the pregnancy outcomes.
Head of the Gynecologic Endoscopy Division, Laparascopy Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Saeed
S
Alborzi
Hossein
H
Asefjah
Madihe
M
Amini
Homeira
H
Vafaei
Gooya
G
Madadi
Negar
N
Chubak
Zohre
Z
Tavana
D000022:Abortion, Spontaneous / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D000328:Adult; D036861:Delivery, Obstetric; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy; D007231:Infant, Newborn; D007492:Iran; D010535:Laparoscopy / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D024162:Second-Look Surgery; D000267:Tissue Adhesions; D016896:Treatment Outcome; D014599:Uterus / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery*