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Metroplasty versus expectant management for women with recurrent miscarriage and a septate uterus.

Overview of attention for article published in Cochrane database of systematic reviews, June 2011
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Title
Metroplasty versus expectant management for women with recurrent miscarriage and a septate uterus.
Published in
Cochrane database of systematic reviews, June 2011
DOI 10.1002/14651858.cd008576.pub3
Pubmed ID
Authors

Kowalik CR, Goddijn M, Emanuel MH, Bongers MY, Spinder T, de Kruif JH, Mol BW, Heineman MJ, Kowalik, C R, Goddijn, M, Emanuel, M H, Bongers, M Y, Spinder, T, de Kruif, J H, Mol, Ben Willem J, Heineman, Maas Jan

Abstract

The prevalence of recurrent miscarriage in women with a septate uterus has increased. Restoration of the morphology of the uterus can hypothetically increase live birth rate and subsequent pregnancies in women with a septate uterus and recurrent miscarriage. To determine whether hysteroscopic metroplasty in women with a septate uterus and two or more preceding miscarriages improves pregnancy outcomes. We searched the Cochrane Menstrual Disorders and Subfertility Group Specialised Register (inception to August 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (inception to August 2010),  MEDLINE (1950 to August 2010), EMBASE (1980 to August 2010). PSYCHINFO (1806 to August 2010). In addition we searched trial registers for ongoing and registered trials, conference abstracts and OpenSigle and sources of Grey literature. Only randomised controlled trials (RCTs) that assess the effect on reproductive outcome of hysteroscopic metroplasty in women with a history of two or more preceding miscarriages and a septate uterus were eligible for inclusion. If there had been data to include, two authors would have independently assessed trial quality and extracted data. They would have also contacted study authors for additional information. We collected adverse effects information from the trials. No randomised controlled trials were identified for inclusion. Hysteroscopic metroplasty in women with recurrent miscarriage and a septate uterus is being performed in many countries to improve reproductive outcomes in women.This treatment has been assessed in non-controlled studies, which suggested a positive effect on pregnancy outcomes. However, these studies are biased due to the fact that the participants with recurrent miscarriage treated by hysteroscopic metroplasty served as their own controls. Until now, the effectiveness and possible complications of hysteroscopic metroplasty have never been considered in a randomised controlled trial.Taking this into account there is insufficient evidence to support this treatment in these women. A randomised controlled trial is urgently needed and currently underway (www.studies-obsgyn.nl/trust NTR 1676).

Mendeley readers

The data shown below were compiled from readership statistics for 18 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
India 1 6%
Saudi Arabia 1 6%
Unknown 16 89%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 4 22%
Other 3 17%
Student > Postgraduate 3 17%
Student > Doctoral Student 2 11%
Professor 1 6%
Other 5 28%
Readers by discipline Count As %
Medicine and Dentistry 12 67%
Unspecified 4 22%
Psychology 1 6%
Biochemistry, Genetics and Molecular Biology 1 6%