HİSTERESKOPİ YAPILAN İNFERTİL HASTALARDA GEBELİK SONUÇLARI

Öz

Amaç: Primer, sekonder infertilite tanısı ile başvuran, konjenital veya edinsel uterin pataoloji tespit edilen olgularda histeroskopik onarım sonrası gebelik sonuçlarının incelenmesidir. Gereç ve Yöntem: Bu çalışmada Ocak 2011-Aralık 2014 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doǧum Kliniǧine primer, sekonder infertilite nedeni ile başvuran hastalara H/S yapıldı. Operasyon esnasında herhangi bir konjenital veya edinsel intrauterin patolojisi olan hastalara müdahale edildi. Müdahale edilen 52 hastaya hastane arşiv kayıtlarından elde edilen telefon numaraları aranarak ulaşıldı. Yapılan klinik çalışmayla ilgili bilgi verilip sözlü onamları alındı. Hastaların operasyon öncesi ve sonrası yaş, gravide, parite, yaşayan çocuk ve diǧer demografik yapılarıyla ilgili sorular soruldu. Bu hastaların tamamına önce diagnostik L/S ve H/S yapıldı. Ardından patoloji olduǧu izlenen hastalara operatif H/S ile müdahale edildi. Ardından operasyon sonrası gebelik sonuçları deǧerlendirldi. Bulgular: Primer infertil (PI) %46’ı (n=24) idi. Sekonder infertil (SI) %54’ü (n=28) idi. PI’de gebelik izlenmedi. SI’de ise 65 gebelik izlendi. Bu gebeliklerin%69.23’ü (n=45) spontan abortustu,%10,76’ı (n=7) preterm, %20’i (n=13) term doǧumdu. SI’de hasta başına düşen canlı doǧum oranı %53,5’di. PI’de operasyon sonrası 17 gebelik tespit edildi. Operasyon sonrası PI’de hasta başına canlı doǧum oranı %58,3’tü. Bu gebeliklerin %11,7’si (n=2) spontan abortus, %11,7’si (n=2) preterm doǧum, %76,4’ü (n=13) term doǧumdu. SI’de ise operasyon sonrası 31 gebelik tespit edildi. Operasyon sonrası SI’de hasta başına canlı doǧum oranı %67,8’di. Bu gebeliklerin %32’si (n=10) spontan abortus, %12,9’u (n=4) preterm doǧum, %54,8’i (n=17) term doǧumdu. Sonuç: Uterin kaviteye konjenital veya edinsel bir patoloji nedeni ile müdahale edilen infertil hastalarda operatif H/S sonrası hastaların spontan abortus sayıları azalırken term doǧum ve canlı doǧum sayısında artışlar izlendi.

Anahtar Kelimeler

• infertilite
• konjenital uterin anomali
• histeroskopi
• histerosalpingografi

PREGNANCY OUTCOMES IN INFERTILE PATIENTS WHO HAD HYSTERESCOPY

Öz

Objective: The aim of this study was to evaluate pregnancy outcomes after hysteroscopic repair in women presenting with primary (PI) or secondary (SI) infertility. Materials and Methods: The study included patients with congenital or acquired intrauterine pathology who presented to the Obstetrics and Gynecology department between January 2011 and December 2014 with PI or SI infertility and underwent hysteroscopy. Following the surgical procedure, the pregnancy outcomes were evaluated. The time between operation and pregnancy, complications during pregnancy and live birth rates were compared. Results: According to infertility status, 46% (n=24) PI and 54% (n=28) SI cases were included in the study. The time to pregnancy after surgery was 14.42±5.7 months in PI and 14±4.71 months in SI. Infertility status did not make a difference in the time to conception (p=0.987). Following the surgical procedure, 17 live births were documented in the PI group. The rate of live birth per patient in the post-operative period was 58.3%. In the SI group, this rate was 67.8%. Conclusion: In the study, we found that the number of live pregnancies increased during the follow-up period in the patients we followed up after the operation. We concluded that it is useful to evaluate the uterine cavity with hysteroscopy even if hysterosalpingography is normal in infertile patients and that intervention in the uterine cavity for any reason positively affects pregnancy outcomes and that the first two years after the operation is the most suitable period for couples to conceive. Abstract Objective: The aim of this study was to evaluate pregnancy outcomes after hysteroscopic repair in women presenting with primary (PI) or secondary (SI) infertility. Materials and Methods: The study included patients with congenital or acquired intrauterine pathology who presented to the Obstetrics and Gynecology department between January 2011 and December 2014 with PI or SI infertility and underwent hysteroscopy. Following the surgical procedure, the pregnancy outcomes were evaluated. The time between operation and pregnancy, complications during pregnancy and live birth rates were compared. Results: According to infertility status, 46% (n=24) PI and 54% (n=28) SI cases were included in the study. The time to pregnancy after surgery was 14.42±5.7 months in PI and 14±4.71 months in SI. Infertility status did not make a difference in the time to conception (p=0.987). Following the surgical procedure, 17 live births were documented in the PI group. The rate of live birth per patient in the post-operative period was 58.3%. In the SI group, this rate was 67.8%. Conclusion: In the study, we found that the number of live pregnancies increased during the follow-up period in the patients we followed up after the operation. We concluded that it is useful to evaluate the uterine cavity with hysteroscopy even if hysterosalpingography is normal in infertile patients and that intervention in the uterine cavity for any reason positively affects pregnancy outcomes and that the first two years after the operation is the most suitable period for couples to conceive.

Anahtar Kelimeler

• Congenital uterine abnormality
• hysterosalpingography
• hysteroscopy
• infertility

Kaynakça

1. Referanslar