RESUMO
OBJECTIVE: To assess the safety and efficacy of hysteroscopic adhesiolysis in patients with recurrent pregnancy loss and infertility. DESIGN: Retrospective case report series. SETTING: The obstetrics and gynecology clinic of a medical school. PATIENT(S): Forty women with recurrent pregnancy loss or infertility resulting from intrauterine adhesions. INTERVENTION(S): Hysteroscopic adhesiolysis in patients with recurrent pregnancy loss and infertility. MAIN OUTCOME MEASURE(S): Postoperative adhesion formation, intraoperative complication, conceivement after surgery, pregnancy rate, and pregnancies resulted in term or viable preterm infants. RESULT(S): Most patients with minimal or moderate adhesions were free of adhesions when compared with postoperative control subjects. However, adhesion re-formation was noted in 60% of the patients who initially had severe adhesions. Normal menstrual flow was restored in 81% of the patients. All the patients who had recurrent pregnancy loss conceived after treatment, and 71% of the pregnancies resulted in a term or viable preterm infant. Of the 16 infertile patients treated, 10 (63%) conceived and 6 (37%) were delivered of viable infants. CONCLUSION(S): Hysteroscopic adhesiolysis is a safe and effective procedure for restoring the normal menstrual pattern and fertility. The initial severity of the adhesions appears to correlate best with the reproductive outcome.
Assuntos
Fertilidade , Histeroscopia , Infertilidade Feminina/cirurgia , Menstruação , Doenças Uterinas/cirurgia , Adulto , Feminino , Humanos , Infertilidade Feminina/etiologia , Gravidez , Estudos Retrospectivos , Aderências Teciduais/cirurgia , Resultado do Tratamento , Doenças Uterinas/complicaçõesRESUMO
Reports of tubal microsurgical transposition techniques to restore fertility are quite rare. In this article, an interesting microsurgical procedure, in a woman with congenital uterine and tubal abnormality is presented. Under certain circumstances, microsurgical transposition of the human fallopian tube has the potential of being a useful therapeutic alternative.