Comparative Study between Effect of Hysteroscopic Uterine Septal Resection and Effect of Expectant Management on Reproductive Outcome in Women with Septate Uterus

doi:https://doi.org/10.21608/aimj.2025.446673

Comparative Study between Effect of Hysteroscopic Uterine Septal Resection and Effect of Expectant Management on Reproductive Outcome in Women with Septate Uterus

Document Type : Original Article

https://doi.org/10.21608/aimj.2025.446673

Abstract

Background: A Septate uterus, a congenital defect characterized by a fibrous band known as a septum, can be treated surgically via hysteroscopic uterine septal resection (HUSR). Women who have a septate uterus may have better reproductive success after this operation, which entails removing the septum.
Aim: To evaluate the efficacy of HUSR in relation to expectant management in achieving a successful pregnancy in women who have a septate uterus.
Subjects and methods: One hundred pregnant women participated in this randomized clinical trial that ran from April 2023 through February 2025 at the obstetrics outpatient clinic of Al-Hussain Hospital, Al-Azhar University.
Results: Significant differences were observed in several secondary outcomes. Clinical pregnancy achievement rates differed significantly between groups (p=0.001), though interestingly, pregnancy loss rates were identical (22% in both groups, p=0.386). Statistically, the SR group had a higher rate of successful continuation of pregnancy (36% vs. 28%, p=0.028). Most significantly, the SR group had a lower rate of preterm births (6% vs. 26%, p=0.001) than the EM group. There were no statistically significant variations in the frequencies of multiple pregnancies, ectopic pregnancies, or placental abortions across the groups. However, the marked difference in preterm birth rates (EM: 26% vs. SR: 6%, p=0.001) represents one of the most clinically significant findings of this study.
Conclusion: The significant reduction in preterm birth rates following septal resection may influence clinical decision-making, particularly in patients with previous adverse pregnancy outcomes. The low complication rates associated with the surgical procedure also support its consideration as a safe treatment option.

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