[Hysteroplasty for hemi-uterus and divided uterus. Apropos of 45 cases]

The authors present a series of 45 plastic operations for bicornuate uterus. Three women were operated on for functional symptoms, eight for sterility of which seven were primary, and thirty four for infertility. They are sorry that three women were lost to follow up. They used the Bret-Palmer technique with modifications that they themselves describe. They justify this choice as against other techniques of metroplasty. The anatomical results are, in the main, good when controlled by hysterosalpingography 3 to 6 months after the operation. The functional results, by which is meant the pregnancies that have been obtained, are medium as far as sterility is concerned. Four out of the eight women who were operated on became pregnant. But they are very good in cases of infertility, because thirty out of the thirty four cases that were operated on had one or two pregnancies. The authors justify their indications for metroplasty after a first spontaneous abortion by the good results they have had, and because bicornuate uteri give rise to many obstetrical complications. Furthermore in unoperated cases there is often difficulty in attempting a new pregnancy, and quite often spontaneous late abortions or premature labours. In certain cases they carried out the operation after first spontaneous abortions, but they are more conservative in operating in cases of primary sterility. The authors do not think it is necessary always to carry out a cerclage procedure nor a caesarean operation automatically in cases that have become pregnant after metroplasty.