Reproductive capacity and outcome of pregnancy after metroplasty following the technique of Bret-Palmer partially modified in the pathological symmetric malformations of müllerian ducts.

During the period 1977-90, metroplasty for infertility and unexplained sterility was performed respectively in 19 and 6 cases of symmetric uterine malformations. The Bret-Palmer technique was used in 6 cases for partial septate uterus, while the same modified technique was performed in 11 cases of complete bicornuate uterus and in 8 cases of partial bicornuate uterus. No operative and postoperative complications were noted. With the modified Bret-Palmer operation there was the reconstruction of a single, large and regular uterine cavity. Of the 17 cases with adequate follow-up pregnancy occurred in 14 cases within 24 months of the operation; in 4 patients the outcome of pregnancy is not known. Of the remaining cases the pregnancy ended in spontaneous abortion in 2 patients, in 6 cases with live term infants and in 2 cases with live preterm infants. Caesarean section was performed electively in 3 cases and acutely in 3 cases. A vaginal delivery occurred in 2 cases. Benefits of the Bret-Palmer modified technique are discussed.