title: Assessment of Abdominal Ultrasound Guidance in Hysteroscopic Metroplasty.
abstract: OBJECTIVE
  To compare the rates of re-intervention, and immediate and later complications associated with abdominal ultrasound-guided versus unguided hysteroscopic metroplasty in the surgical repair of European Society of Human Reproduction and Embryology/European Society for Gynecological Endoscopy class II intrauterine septa.
  
  
  METHODS
  We performed a large observational retrospective study (Canadian Task Force Classification II-2) in a selection of patients who underwent metroplasty in a tertiary university center between 2009 and 2013.
  
  
  METHODS
  A total of 108 patients were included in the study.
  
  
  METHODS
  Patients were categorized as having abdominal ultrasound-guided metroplasty (n = 46) or unguided metroplasty (n = 62).
  
  
  RESULTS
  Data were collected with regard to medical and reproductive histories, diagnosis of septate uterus, surgical procedures, and complications. Using these data, the need for re-intervention and complication rates were compared between groups. Statistical analysis was performed using Fisher's exact test and Student's t-test. The characteristics of the 2 groups were comparable. A persistent septum of >10 mm, defined by 3-dimensional ultrasound hysterosonography, with a need for re-intervention, was found in 16 patients (39.0 %) in the unguided group versus 7 patients (18.4 %) in the ultrasound guidance group (p = .04). Risk of a persistent septum after resection (>10 mm) was reduced with ultrasound guidance (odds ratio = 0.35; 95% confidence interval 0.13-0.99). Two uterine perforations occurred in our series; both were in the unguided group.
  
  
  CONCLUSIONS
  A systematic abdominal ultrasound-guided metroplasty by hysteroscopy seems to reduce the rates of re-intervention.
authors: Bicêtre University Hospital Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France; INSERM UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Paris-Sud University, Le Kremlin Bicêtre, France.
authors: Solène
authors: S
authors: Vigoureux
authors: Bicêtre University Hospital Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France; INSERM UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Paris-Sud University, Le Kremlin Bicêtre, France.
authors: Hervé
authors: H
authors: Fernandez
authors: Bicêtre University Hospital Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France; INSERM UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Paris-Sud University, Le Kremlin Bicêtre, France.
authors: Perrine
authors: P
authors: Capmas
authors: Bicêtre University Hospital Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France.
authors: Jean-Marc
authors: JM
authors: Levaillant
authors: Angers University Hospital, Angers, France; INSERM UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Paris-Sud University, Le Kremlin Bicêtre, France. Electronic address: g_legendre@hotmail.com.
authors: Guillaume
authors: G
authors: Legendre
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D061705:Image-Guided Biopsy; D011247:Pregnancy; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*; D013519:Urogenital Surgical Procedures; D014595:Uterine Perforation / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Hysteroscopy; Metroplasty; Müllerian malformation; Ultrasound guidance; Uterine septa