Uterine Septum with or without Hysteroscopic Metroplasty: Impact on Fertility and Obstetrical Outcomes—A Systematic Review and Meta-Analysis of Observational Research

Marco Noventa; Giulia Spagnol; Matteo Marchetti; Carlo Saccardi; Giulio Bonaldo; Antonio Simone Laganà; Francesco Cavallin; Alessandra Andrisani; Guido Ambrosini; Salvatore Giovanni Vitale; Luis Alonso Pacheco; Sergio Haimovich; Attilio Di Spiezio Sardo; Jose Carugno; Marco Scioscia; Simone Garzon; Stefano Bettocchi; Giovanni Buzzaccarini; Roberto Tozzi; Amerigo Vitagliano

doi:10.3390/jcm11123290

Journal of Clinical Medicine (Jun 2022)

Uterine Septum with or without Hysteroscopic Metroplasty: Impact on Fertility and Obstetrical Outcomes—A Systematic Review and Meta-Analysis of Observational Research

Marco Noventa,
Giulia Spagnol,
Matteo Marchetti,
Carlo Saccardi,
Giulio Bonaldo,
Antonio Simone Laganà,
Francesco Cavallin,
Alessandra Andrisani,
Guido Ambrosini,
Salvatore Giovanni Vitale,
Luis Alonso Pacheco,
Sergio Haimovich,
Attilio Di Spiezio Sardo,
Jose Carugno,
Marco Scioscia,
Simone Garzon,
Stefano Bettocchi,
Giovanni Buzzaccarini,
Roberto Tozzi,
Amerigo Vitagliano

Affiliations

Marco Noventa: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy
Giulia Spagnol: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy
Matteo Marchetti: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy
Carlo Saccardi: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy
Giulio Bonaldo: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy
Antonio Simone Laganà: Unit of Gynecology Oncology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities (PROMISE), University of Palermo, 90127 Palermo, Italy
Francesco Cavallin: Independent Researcher, 36020 Solagna, Italy
Alessandra Andrisani: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy
Guido Ambrosini: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy
Salvatore Giovanni Vitale: Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy
Luis Alonso Pacheco: Endoscopy Unit, Centro Gutenberg, 29003 Málaga, Spain
Sergio Haimovich: Hillel Yaffe Medical Center, Technion-Israel Technology Institute, Hadera 38100, Israel
Attilio Di Spiezio Sardo: Department of Public Health, School of Medicine, University of Naples Federico II, 80138 Naples, Italy
Jose Carugno: Minimally Invasive Gynecology Unit, Obstetrics, Gynecology and Reproductive Sciences Department, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
Marco Scioscia: Unit of Gynecology, Mater Dei Hospital, 70125 Bari, Italy
Simone Garzon: Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, 37126 Verona, Italy
Stefano Bettocchi: Inter-Departmental Project Unit of Minimal-Invasive Gynecological Surgery, Policlinico of Bari, University of Bari Aldo Moro, 70121 Bari, Italy
Giovanni Buzzaccarini: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy
Roberto Tozzi: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy
Amerigo Vitagliano: Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35100 Padua, Italy

DOI: https://doi.org/10.3390/jcm11123290
Journal volume & issue: Vol. 11, no. 12
p. 3290

Abstract

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Objective: we performed a systematic review/meta-analysis to evaluate the impact of septate uterus and hysteroscopic metroplasty on pregnancy rate-(PR), live birth rate-(LBR), spontaneous abortion-(SA) and preterm labor (PL) in infertile/recurrent miscarriage-(RM) patients. Data sources: a literature search of relevant papers was conducted using electronic bibliographic databases (Medline, Scopus, Embase, Science direct). Study eligibility criteria: we included in this meta-analysis all types of observational studies that evaluated the clinical impact of the uterine septum and its resection (hysteroscopic metroplasty) on reproductive and obstetrics outcomes. The population included were patients with a diagnosis of infertility or recurrent pregnancy loss. Study appraisal and synthesis methods: outcomes were evaluated according to three subgroups: (i) Women with untreated uterine septum versus women without septum (controls); (ii) Women with treated uterine septum versus women with untreated septum (controls); (iii) Women before and after septum removal. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for the outcome measures. A p-value p p p p = 0.0004). (ii) treated versus untreated septum: PR and PL were not different in removed vs. unremoved septum(OR 1.10, 95% CI 0.49–2.49; p = 0.82 and OR 0.81, 95% CI 0.35–1.86; p = 0.62); a lower proportion of SA was associated with removed vs. unremoved septum (OR 0.47, 95% CI 0.21–1.04; p = 0.001); (iii) before-after septum removal: the proportion of LBR was higher after the removal of septum (OR 49.58, 95% CI 29.93–82.13; p p p < 0.0001) Conclusions: the results show the detrimental effect of the uterine septum on PR, LBR, SA and PL. Its treatment reduces the rate of SA.

Published in Journal of Clinical Medicine

ISSN: 2077-0383 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine
Website: http://www.mdpi.com/journal/jcm

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