Uterine factor in repeated abortion, hysteroscopic, hysterographic and ultrasonographic study

ABSTRACT

Recurrent abortion is a frustrating problem due to the despair of being unproductive in spite of conception. Uterine factor represents a contributing element in that problem. This work comprised 120 patients presenting with history of recurrent abortion. All patients were subjected to careful history taking and clinical examination. Hysterography, ultrasonography and hysteroscopy were performed for all cases. It was revealed that hysteroscopy and hysterography were nearly equal in diagnosing uterine anomalies and both methods were superior to ultrasonogrphy. However, hysterography can not precisely differentiate bicornuate from septate uterus, whereas hysteroscopy was more informative about extent and thickness of the septum. As regard fibroid uterus, both hysteroscopy and hysterography were equal in diagnosing submucos myomata, whereas ultrasonography was much more superior in diagnosing intra-mural and subserous myomata. Operative hysteroscopy resulted in successful division of uterine septum in 89% of cases and incomplete procedure in 11% of cases. Hysteroscopic adhesiolysis of synechiae resulted in successful procedure in 55% of cases, incomplete procedure in 13% and failed procedure in 32% of cases