Impact of Hysteroscopic Metroplasty on Reproductive Outcomes of Women with a Dysmorphic Uterus and Recurrent Miscarriages: A Systematic Review and Meta-Analysis
Autor: | Gaetano Riemma, Antonio Cianci, Pasquale De Franciscis, Nicola Colacurci, Marco La Verde, Antonio Schiattarella, Franziska Michaela Lohmeyer, Salvatore Giovanni Vitale, Luigi Cobellis |
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Přispěvatelé: | De Franciscis, P., Riemma, G., Schiattarella, A., Cobellis, L., Colacurci, N., Vitale, S. G., Cianci, A., Lohmeyer, F. M., La Verde, M. |
Rok vydání: | 2020 |
Předmět: |
Adult
medicine.medical_specialty Abortion Habitual Metroplasty Gestational Age Hysteroscopy Recurrent miscarriage law.invention Miscarriage 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Pregnancy medicine Humans 030219 obstetrics & reproductive medicine medicine.diagnostic_test Obstetrics business.industry Uterus Obstetrics and Gynecology Reproductive outcomes medicine.disease Systematic review Treatment Outcome Reproductive Medicine 030220 oncology & carcinogenesis Meta-analysis Relative risk Female Live birth business Live Birth Dysmorphic uteru |
Zdroj: | Journal of gynecology obstetrics and human reproduction. 49(7) |
ISSN: | 2468-7847 |
Popis: | The aim of this systematic literature review and meta-analysis is to assess the impact of hysteroscopic metroplasty for dysmorphic uteri on reproductive outcomes in women with recurrent miscarriages. Available studies were identified through a PubMed, Scopus, and Cochrane search until June 2019. Live-birth rate, clinical pregnancy and miscarriage rate after hysteroscopic metroplasty was evaluated. DerSimonian and Laird’s random-effect model was used for relative risks, Freeman-Tukey Double Arcsine for pooled estimates and exact method to stabilize variances and CIs. Heterogeneity was quantified using I2-statistics. Six out of 164 published studies met the inclusion criteria. All (n = 221) women underwent metroplasty, using 5Fr-hysteroscope with bipolar electrodes or 26Fr/28Fr-resectoscope in outpatient or inpatient settings. After 6 to 60-month follow-up, reported live-birth rate was 50% (0.37-0.63 95% CI) from a clinical pregnancy rate of 73% (0.51-0.91 95% CI) and miscarriage rate was 23% (0.15-0.30 95% CI). Hysteroscopic metroplasty for dysmorphic uteri led half of the women who experienced recurrent miscarriages at least one live birth and is correlated to few surgical and obstetric complications. However, randomized clinical trials and case-control studies are unavailable due to ethical constrains; inhomogenity of follow-up durations and standardized protocols regarding preoperative diagnosis and post-surgical management resrict our conclusions. |
Databáze: | OpenAIRE |
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