双頸を伴った完全中隔子宮に対し子宮鏡下子宮中隔切除を行ったのち妊娠成立し、生児を得た1例

抄録

  A 37-year-old woman, gravida 1, para 0, was referred to our hospital because of uterine malformation. Pelvic examination revealed a longitudinal vaginal septum and doubled uterine cervix. Magnetic resonance imaging revealed no external fundal indentation, a complete uterine septum, and cervical duplication.

  We performed vaginal septectomy and hysteroscopic metroplasty. After the resection of the vaginal septum, we inserted the Hegar dilator into the right cervical os and pushed it against the wall to reveal the position of the septum. Next, we incised the corporal portion of the septate uterus by using a loop- type monopoles electrode. We placed the intrauterine device (IUD; FD-1 Fuji Latex Co., Ltd.) in the uterine cavity. We removed the IUD after two cycles of Kaufmann therapy.

  Seven months after the operation, she became pregnant spontaneously. During pregnancy, no symptoms indicating a threatened abortion or premature delivery were observed. We performed a cesarean section because of breech presentation at 38 weeks 4 days of gestation. No serious complications such as uterine rupture and placenta accrete occurred.

  Hysteroscopic metroplasty for septate uterus seems to be a simple and relatively safe procedure, and seems to improve the obstetric outcome in a population of women with previous miscarriages. After operation, careful management is necessary during pregnancy and labor.