Relationships between the angle of the endometrium of two sides of the septum and mediastinal residue after TCRS, and pregnancy outcome

ObjectiveTo investigate the relationships between the angle of the endometrium of two sides of the septum, and mediastinal residue after transcervical hysteroscopic resection of septum(TCRS) and pregnancy outcome.

MethodsThe mediastinal uterus in 80 patients with infertility or abortion were diagnosed using 3DTVU, and the patients were treated with hysteroscopy combined with TCRS.According to the results of 3DTVU, the patients were divided into the large angle group(the angle of the endometrium of two sides of the septum ≥ 90°) and small angle group(the angle of the endometrium of two sides of the septum < 90°).The postoperative mediastinal length more than 0.5 cm was set as the criteria of mediastinal residue.All patients were reviewed and followed up.

ResultsThe results of TCRS and preoperative diagnosis of 3DTVU were the same.At 3 months after surgery, no mediastinal residue or no more than 0.5 cm residue in 59 cases, and mediastinal residue more than 0.5 cm in 21 cases were found.The residue rate in large angle group(43.48%) was significantly higher than that in small angle group(15.79%)(P < 0.01).The mediastinal length more than 1 cm in 1 case in large angle group and 1 case in small angle group was found, and two cases were treated with operation again.Three cases with intrauterine adhesion in large angle group were found, and treated with adhesion lysis.The follow-up rate of patients was 80.00%.The cumulative pregnancy rate and cumulative live birth rate in large angle group and small angle group were(52.63% and 44.44%) and(21.05% and 33.33%), respectively, and the differences of those between two groups were not statistically significant(P>0.05).One case with spontaneous abortion in large angle group and 3 cases with spontaneous abortion in small angle group were found, and the difference of which between two groups was not statistically significant(P>0.05).

ConclusionsThe effects of the angle of the endometrium of two sides of the septum on the pregnancy outcome after TCRS may be related to the incidence rate of postoperative complications, which need to be further studied.