EFFECTIVENESS OF METROPLASTY ON BICORNUATE UTERUS
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概要
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Of 29 women with a bicornuate uterus, 18 patients with a poor obstetric history were undertaken Jones-Jones operation and pre- and postoperative pelvic angioraphy with histerosalpingography (PAG-HSG). The remaining 11 patients without surgical treatment were observed during pregnancy and the placental sites were studied ultrasonographically. The following results were obtained: 1) Preoperative PAG-HSG revealed that the septal area was poor in vascularity, while postoperative PAG-HSG revealed that the vascularity of the uterus had generally improved. 2) The nine excised septa showed histologically poor vascular distribution. The average number of blood vessels in 40 fields at × 200 magnification was 119±38 in the septal tissue. This value was significantly lower than 235±51 in the control gourp. However, in the endometrial datings between the septum and other sites of the uterus, no difference could be found. 3) The over-all fetal salvage rate was improved from 0% before the metroplasty to 72.2% after the metropalasty. 4) In the ultrasonographical study of the pregnant bicornuate uteri, the placenta was shown to locate mainly from the middle to upper-middle segments of the uterine corpus when viewed by longitudinal scan; and from the anterior or posterior to lateral wall of the uterine corpus when viewed by transverse scan. Although threre was one term delivery in which septal attachment of the succenturiate placenta occurred, there were no cases to suggest the septal implantation. From these results, it was concluded that the presence of a septum did not always hinder the implantation of the fertilized ovum. Nevertheless, Jones-Jones operation not only improved the uterine cavity morphologically but also provided a good environment for the conceptus through the improvement of the uterine vascularity.
- 名古屋市立大学の論文
- 1982-11-12