HOME-DU (Hysteroscopic Outpatient Metroplasty to Expand

Dysmorphic Uteri) technique

Prof. Pasquale FLORIO U.O.C. Ginecologia ed Ostetricia

Ospedale “S. Iacopo”,

AUSL 3 – PISTOIA -

Malformazioni uterine: classificazione

Zlopasa et al., Int J Gynecol Obstet, 2007

Malformazioni uterine: quale outcome riproduttivo?

Malformazioni uterine: quale chirurgia mini-invasiva?

Malformazioni uterine: classificazione

Utero “a T” o Utero infantile

HOME-DU (Hysteroscopic Outpatient Metroplasty to Expand

Dysmorphic Uteri) technique

Ø 4-5 mm

HOME-DU (Hysteroscopic Outpatient Metroplasty to Expand

Dysmorphic Uteri) technique

Table I : Main characteristics of the enrolled patients

Age (years) (mean ± SD) 32 ± 3.1

Body Mass Index (BMI) 24.6 ± 2.8

History of DES exposure 0/30 (0%)

Indication for the HOME-DU procedure

IVF failure 11/30 (36.7%)

At least one early miscarriage 19/30 (63.3%)

Subtypes of “dysmorphic uteri”

T-shaped uterus 12/30 (40%)

Tubular-shaped/infantilis uterus 18/30 (60%)

Uterine volume at enrolment (cm3) 1.4 ± 0.2

I /IO ratio at enrolment

T-shaped uterus 0.35 ± 0.07

Tubular-shaped uterus 0.67 ± 0.1

I /IO ratio after HOME-DU surgery

T-shaped uterus 0.62 ± 0.05*

Tubular-shaped uterus 0.55 ± 0.11**

I : transverse diameter at the level of Isthmus

IO : Interostial distance

*P: .002 vs the I/IO ratio at enrollment.

**P: .007 vs the I/IO ratio at enrollment.

Da Giugno 2012 a Marzo 2013

Table I : Main characteristics of the enrolled patients

Age (years) (mean ± SD) 32 ± 3.1

Body Mass Index (BMI) 24.6 ± 2.8

History of DES exposure 0/30 (0%)

Indication for the HOME-DU procedure

IVF failure 11/30 (36.7%)

At least one early miscarriage 19/30 (63.3%)

Subtypes of “dysmorphic uteri”

T-shaped uterus 12/30 (40%)

Tubular-shaped/infantilis uterus 18/30 (60%)

Uterine volume at enrolment (cm3) 1.4 ± 0.2

I /IO ratio at enrolment

T-shaped uterus 0.35 ± 0.07

Tubular-shaped uterus 0.67 ± 0.1

I /IO ratio after HOME-DU surgery

T-shaped uterus 0.62 ± 0.05*

Tubular-shaped uterus 0.55 ± 0.11**

I : transverse diameter at the level of Isthmus

IO : Interostial distance

*P: .002 vs the I/IO ratio at enrollment.

**P: .007 vs the I/IO ratio at enrollment.

Table 2: Post-operative reproductive outcomes

Inclusion criteria Pregnancy Abortion rate Term delivery rate Live birth rate

Primary infertility (n=22) 12/22

(55%)

3/12

(25%)

9/12

(75%)

9/12

(75%)

Repeated early abortions (! 2)

(n=7)

5/7

(71%)

2/5

(40%)

2/5

(40%)

3/5

(60%)

Preterm delivery

(n=1)

0/1

(0,0%)

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HOME-DU (Hysteroscopic Outpatient Metroplasty to Expand

Dysmorphic Uteri) technique