title: Pregnancy Complications After Hysteroscopic Metroplasty: A Ten-Year Case-Control Study.
abstract: BACKGROUND
  Septate uterus is one of the most common congenital uterine anomalies and it may effect female reproductive health causing different obstetric complications, in particular miscarriages and reduction of fertility.
  
  
  METHODS
  We conducted a retrospective case-control (1:4) comparative study (Canadian Task Force Classification II-2) with the purpose to evaluate pregnancy complications (abnormal fetal presentations, preterm deliveries, and caesarean sections) and reproductive outcome after hysteroscopic metroplasty. We studied retrospectively two groups: 62 women that delivered after metroplasty (group A); and a control group of 248 women with no history of hysteroscopic metroplasty that delivered in the same period in our hospital (group B).
  
  
  RESULTS
  The rate of abnormal fetal presentations was significantly higher in study group A versus control group B (22.58% [14/62] vs. 4.03% [10/248], p<0.0001). Caesarean section rate was significantly higher in group A versus group B (66.12% [41/62] vs. 35.08% [87/248], p<0.0001), and preterm deliveries rate was significantly higher in group A versus group B (14.51% [9/62] vs. 6.45% [16/248], p= 0.037). Furthermore, in group A, we observed a significant reduction of the abortion rate and an increase in the total number of live births after metroplasty.
  
  
  CONCLUSIONS
  In our series of cases, we have observed a high rate of some pregnancy complications after metroplasty compared to the general population, such as preterm deliveries and fetal malpresentations with a higher rate of caesarean sections. Hysteroscopic metroplasty has been proven to improve the overall reproductive outcome by reducing miscarriage rate and increasing live birth rate. In our opinion, benefits obtained after metroplasty must be considered greater than the adverse pregnancy outcomes observed with our series.
authors.affiliation: Obstetrics-Gynecology Clinic and Pathophysiology of Human Reproduction Unit, Department of Surgical Sciences, University Hospital of Cagliari, Sardinia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Loddo
authors.affiliation: Obstetrics-Gynecology Clinic and Pathophysiology of Human Reproduction Unit, Department of Surgical Sciences, University Hospital of Cagliari, Sardinia, Italy.
authors.forename: Maurizio Nicola
authors.initials: MN
authors.lastname: D'Alterio
authors.affiliation: Obstetrics-Gynecology Clinic and Pathophysiology of Human Reproduction Unit, Department of Surgical Sciences, University Hospital of Cagliari, Sardinia, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Neri
authors.affiliation: Obstetrics-Gynecology Clinic and Pathophysiology of Human Reproduction Unit, Department of Surgical Sciences, University Hospital of Cagliari, Sardinia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Masala
authors.affiliation: Obstetrics-Gynecology Clinic and Pathophysiology of Human Reproduction Unit, Department of Surgical Sciences, University Hospital of Cagliari, Sardinia, Italy.
authors.forename: Fiorenza Lo
authors.initials: FL
authors.lastname: Cane
authors.affiliation: Obstetrics-Gynecology Clinic and Pathophysiology of Human Reproduction Unit, Department of Surgical Sciences, University Hospital of Cagliari, Sardinia, Italy.
authors.forename: Gian Benedetto
authors.initials: GB
authors.lastname: Melis
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014599:Uterus / Q000601:surgery*