Introducere. Malformaţiile uterine congenitale (MUC) afectează 4-6% dintre femeile de vârstă reproductivă. La pacientele cu infertilitate, avorturi recurente incidenta atinge 12%. Uterul septat (US) este cea mai frecventă MUC, cu o incidenta de 35% si este deseori nedepistat, fiind una din cauzele infertilităţii. Scop. Evaluarea rezultatelor reproductive după metroplastia histeroscopică (MH) la pacientele cu Uter Septat, care suferă de infertilitate sau pierderi recurente de sarcină. Material şi metode. A fost efectuat un studiu retrospectiv în care au fost incluse 22 de paciente diagnosticate cu MUC, tratate prin MH. A fost efectuat şi o revizuire sistematică a literaturii de specialitate incluzând studii observaţionale, meta-analize ce au evaluat impactul MH asupra pacientelor cu MUC care suferă de infertili-tate, pierderi recurente de sarcină. Rezultate. În studiul efectuat s-a observat că >70% au avut vârstă >33 de ani subliniind diagnosticul tardiv a MUC. Principala acuză a fost infertilitatea 68,18% I, 31,81% II. Anamneza ginecologică: chiuretaj uterin 22,72%, eşec FIV 13,63%, pierderea sarcinii precoce 13,63%, naştere prematură 9,09%.Conform clasificării MUC ESHRE/ESGE 90,91%, au avut dg US clasa U2 şi 9,09% uter dismorfic U1. USG 2D/3D s-a diagnosticat si: adenomioză; sinechii intrauterine; istmocel; polipi endo-metriali. Rata de sarcina post-MH 46%, din care 50% spontan si 50% FIV, finalizate cu naştere la termen, 45% paciente sunt monitorizate pentru a obţine sarcină, 9% nu doresc sarcină. Concluzii. MH este standardul de aur în tratamentul MUC, crescând şansele de sarcină şi reducând riscul de avort, naştere prematură. Studiul subliniază importanţa diagnosticării precoce prin ecografie 2D/3D şi managementul chirurgical personalizat pentru optimizarea şanselor reproductive la pacientele cu MUC.
Introduction. Congenital uterine malformations (CUM) affect 4-6% of women of reproductive age. Among patients with infertility and recurrent spontaneous abortions, the incidence is 12%. The septate uterus (SU) is the most common type of CUM, and affect 35%. SU frequently remains undiagnosed, contributing to infertility. Objective. To evaluate reproductive outcomes following hysteroscopic metro-plasty (HM) in patients with Septate Uterus and a history of infertility or recurrent pregnancy loss. Material and methods. This study involved a retrospective evaluation of 22 patients, diagnosed with CUM, who underwent HM. A complementary review of the literature was also performed (observational studies, meta-analyses) found in electronic databases, focusing on how HM influences fertility outcomes in women with infertility and recurrent pregnancy loss. Results. In our study >70% were >33 years, suggesting a delayed diagnosis of CUM. The main reason was infertility 68.18% I, 31.81% II. Gynecological history: uterine curettage 22.72%, IVF failure 13.63%, early pregnancy loss 13.63%, preterm birth 9.09%. According ESHRE/ESGE classification, 90.91% were diagnosed with SU Class U2, 9.09% with a dysmorphic uterus Class U1. 2D/3D ultrasound revealed: adenomyosis, intrauterine synechiae, isthmocele, endometrial polyps. The post-HM fertility rate 46%, 50% achieved spontaneously and 50% via IVF, all resulted in term deliveries. 45% of patients are currently under follow-up, while 9% are not pursuing conception. Conclusion. HM is the gold standard in the treatment of CUM, significantly improving pregnancy outcomes and reducing the risk of miscarriage, preterm delivery. This study underscores the importance of early diagnosis through 2D/3D US and a personalized surgical approach to optimize reproductive outcomes.
