Cervical Septum Incision Adversely Impacts Clinical Outcomes in Women with Complete Uterine Septum and Duplicated Cervix

Ninghong Jiang; Yu Xie; Wenjie Qu; Lei Lei; Shujun Gao; Hongwei Zhang; Qing Wang; Limei Chen; Long Sui

doi:10.1016/j.jmig.2024.05.012

Cervical Septum Incision Adversely Impacts Clinical Outcomes in Women with Complete Uterine Septum and Duplicated Cervix

J Minim Invasive Gynecol. 2024 May 11:S1553-4650(24)00217-6. doi: 10.1016/j.jmig.2024.05.012. Online ahead of print.

Authors

Ninghong Jiang¹, Yu Xie¹, Wenjie Qu¹, Lei Lei¹, Shujun Gao¹, Hongwei Zhang¹, Qing Wang¹, Limei Chen¹, Long Sui²

Affiliations

¹ Medical Center for Diagnosis and Treatment of Uterine Cavity and Tubal Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China (all authors).
² Medical Center for Diagnosis and Treatment of Uterine Cavity and Tubal Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China (all authors).. Electronic address: suilong@sh163.net.

PMID: 38740131
DOI: 10.1016/j.jmig.2024.05.012

Abstract

Study objective: To investigate the reproductive outcomes of women with complete septate uterus and duplicated cervix who either did or did not receive cervical septum incision during hysteroscopic transcervical incision of the uterine septum.

Design: Retrospective study approved by the hospital ethics committee.

Setting: Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Patients: Women with complete septate uterus and duplicated cervix who underwent hysteroscopic transcervical incision of the uterine septum in Obstetrics and Gynecology Hospital of Fudan University between January 2008 and December 2020 (n = 105).

Interventions: Hysteroscopic incision of the septum.

Measurements and main results: Included patients were grouped according to whether or not cervical septum incision was performed. Reproductive outcomes including gravidity, abortion rate, preterm birth rate, full-term birth rate, premature rupture of membranes, and cervical incompetence were assessed. In the no incision group, the abortion rate (7.4%) was significantly lower than that of the incision group (27.6%, p = .01); the preterm birth rate (4.6%) was significantly lower than that of the incision group (36.8%); and the full-term birth rate (95.5%) exceeded that of the incision group (63.2%, p <.01). Incidence of premature rupture of membranes and cervical incompetence during pregnancy was higher in the incision group (15.8% and 10.5%, p <.01 and p = .03).

Conclusion: Significantly improved reproductive outcomes were observed among patients with complete septate uterus and duplicated cervix whose cervical septum was preserved during the hysteroscopic transcervical incision of the uterine septum procedure.

Keywords: Complete septate uterus; Duplicated cervix; Hysteroscopy; Reproductive outcomes.