Ginekol Pol
· 2025 Nov · PMID 41250593
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OBJECTIVES: Recurrent miscarriage is a multifactorial condition, with immune dysregulation proposed as a potential contributing factor. This study investigates the causal relationship between immune cell phenotypes and m...OBJECTIVES: Recurrent miscarriage is a multifactorial condition, with immune dysregulation proposed as a potential contributing factor. This study investigates the causal relationship between immune cell phenotypes and miscarriage risk using Mendelian randomization (MR). MATERIAL AND METHODS: We performed a two-sample MR analysis using genome-wide association study (GWAS) summary statistics from publicly available datasets. The exposure data for immune cell phenotypes were obtained from the ebi-a-GCST90001599 dataset in the IEU GWAS database, which included over 3,000 individuals of predominantly European ancestry from multiple cohorts within the UK Biobank. The outcome data for miscarriage risk were sourced from the UKB-B-419 dataset in the MRC-IEU GWAS database, which analysed the number of spontaneous miscarriages in 78,700 individuals of predominantly European ancestry from the United Kingdom. The primary MR analysis was conducted using inverse-variance weighted (IVW) regression, complemented by Wald ratio and MR-Egger regression methods to assess robustness. MR-PRESSO was used to test for pleiotropy, while sensitivity analyses evaluated instrument validity and heterogeneity. RESULTS: MR-Egger regression did not provide statistically significant evidence for a causal association between immune cell phenotypes and miscarriage risk. However, IVW and Wald ratio analyses identified statistically significant associations between specific immune cell profiles and miscarriage risk. A higher proportion of HLA DR+ CD4+ and CD8+ T cells was associated with an increased risk of miscarriage (p < 0.005), while a higher absolute lymphocyte count was linked to a decreased risk (p = 0.011). Additionally, elevated levels of TCRgd T cells and FSC-A on CD4+ T cells were potentially protective against miscarriage (p < 0.01). Conversely, lower proportions of granulocytes and FSC-A on myeloid dendritic cells were associated with an increased miscarriage risk (p < 0.05). MR-PRESSO detected significant pleiotropy (global test p < 0.001), suggesting that some genetic variants may influence other traits, potentially biasing the initial MR estimates. CONCLUSIONS: Our findings suggest a complex interplay between immune cell composition and miscarriage risk, providing new insights into the immunological mechanisms contributing to pregnancy loss. These results highlight the need for further research to confirm these associations and explore potential therapeutic targets for immune-related pregnancy complications.
Dybowski B, Narojczyk-Swiesciak E, Baranowski W
… +10 more, Rechberger T, Miotla P, Futyma K, Wrobel A, Grzybowska ME, Stangel-Wojcikiewicz K, Kluz T, Rogowski A, Wlazlak E, Surkont G
OBJECTIVES: The aim of this Guideline was to devise a standardized and simplified diagnostic overview of women with urinary urgency and other symptoms indicative of the overactive bladder (OAB) syndrome. MATERIAL AND MET...OBJECTIVES: The aim of this Guideline was to devise a standardized and simplified diagnostic overview of women with urinary urgency and other symptoms indicative of the overactive bladder (OAB) syndrome. MATERIAL AND METHODS: A review of the available literature about the diagnostic processes for the OAB syndrome, in-cluding current international guidelines, original and review articles, was conducted. Data quality, benefit-to-risk ratio, resource availability in Poland, and expert consensus were considered when developing this Guideline. RESULTS: Clinical evaluation of patients with symptoms suggestive of OAB should encompass medical history - general as well as focused, physical examination, and urinalysis. Ultrasound examination of the bladder, with the assessment of post-void residual measurement, as well as a voiding diary might be crucial supplementary diagnostic measures. If the abovementioned management allows us to exclude other causes of the symptoms, the diagnosis of OAB is established and pharmacotherapy may be initiated. Endoscopy, imaging tests other than bladder ultrasound, cytology and uro-dynamics may prove to be necessary if urinary urgency is accompanied by the following: hematuria, pelvic mass, voiding symptoms, pelvic pain, neurological diseases, or other diseases which may affect the functioning of the urinary tract. CONCLUSIONS: A diagnostic scheme for the OAB syndrome, subdivided into the initial and specialized evaluation, was designed. The significance of each test was discussed in the Guideline.
Kosinski P, Janiak K, Borowski D
… +23 more, Brawura-Biskupski-Samaha R, Cnota W, Debska M, Drews K, Grzesiak M, Jaczynska R, Kaczmarek P, Kolesnik A, Lipa M, Litwinska M, Luterek K, Olejek A, Polczynska-Kaniak E, Preis K, Szaflik K, Szymkiewicz-Dangel J, Swiatkowska-Freund M, Wegrzyn P, Wielgos M, Zamlynski J, Zamlynski M, Sieroszewski P, Wloch A
OBJECTIVES: To identify novel marker genes to predict potential gestational diabetes mellitus (GDM) patients. MATERIAL AND:METHODS: Based on Gene Expression Omnibus (GEO) datasets, the differentially expressed genes (DE...OBJECTIVES: To identify novel marker genes to predict potential gestational diabetes mellitus (GDM) patients. MATERIAL AND:METHODS: Based on Gene Expression Omnibus (GEO) datasets, the differentially expressed genes (DEGs) between control and GDM were identified, followed by enrichment analysis and protein-protein interaction (PPI) network construction. Then, Weighted gene co-expression network analysis (WGCNA) was conducted to screen the key module genes, then the important genes were obtained. In addition, Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression, Support Vector Machine - Recursive Feature Elimination (SVM-RFE), and random forest (RF) were employed to identify the key genes. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic efficacy of key genes, and a nomogram was developed. The correlation between key genes and immune cells was analyzed, and miRNA-mRNA-TF network was constructed. RESULTS: A total of 257 DEGs were screened between control and GDM groups, and these DEGs were involved in p53 signaling pathway, cell cycle and oocyte meiosis pathways. Then PPI network was constructed, including 163 nodes and 5502 interaction relationships. After WGCNA and machine learning, a total of 4 key genes were obtained, including SNRPD3, NGDN, ANKRD36 and TAS2R20, followed by a nomogram was constructed. SNRPD3 was positively correlated with CD8 T cells. miRNA-mRNA-TF network was conducted, including 56 miRNAs, 4 mRNAs, and 32 TFs. Besides, luteolin PC3 UP, alsterpaullone PC3 UP, and solanine HL60 UP were associated with NGDN, and MeIQx CTD 00001739 was related to TAS2R20. CONCLUSIONS: Four key marker genes for predicting potential GDM were identified, including SNRPD3, NGDN, ANKRD36 and TAS2R20, and a nomogram was established for predicting potential GDM patients.
Ginekol Pol
· 2025 Oct · PMID 41084365
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OBJECTIVES: We aimed to evaluate the effect of continuous epidural block combined with free positioning on the genital tract injury in parturients undergoing vaginal delivery. MATERIAL AND METHODS: A total of 146 women w...OBJECTIVES: We aimed to evaluate the effect of continuous epidural block combined with free positioning on the genital tract injury in parturients undergoing vaginal delivery. MATERIAL AND METHODS: A total of 146 women who underwent vaginal delivery between January 2021 and December 2022 were divided into control and research groups (n = 73) using a random number table. Based on continuous epidural block, vaginal delivery was performed in a routine obstetric position for the control group and in free positions (sitting, walking, standing, kneeling, squatting, and lying on the side) for the research group. The duration of labor, neonatal asphyxia rate, genital tract injury rate, delivery outcomes, sense of control during childbirth, fear of childbirth, and postpartum fatigue were compared. RESULTS: The research group had significantly shorter first stage of labor, second stage of labor, third stage of labor and total stage of labor than those of the control group (p < 0.05). The two groups had similar Apgar scores of neonates (p > 0.05). In the research group, the neonatal asphyxia rate and genital tract injury rate were significantly lower than those of the control group (p < 0.05). The research group had a higher natural delivery rate and lower rates of conversion to cesarean section and assisted vaginal delivery than those of the control group (p < 0.05). The score of internal control sense, score of external control sense and total score of control sense of the research group were higher than those of the control group (p < 0.05). In the research group, the scores of fears of neonatal health, delivery control, pain and hospital intervention and total score of fear were lower than those of the control group (p < 0.05). The research group had lower scores of immediate postpartum fatigues, 1-h postpartum fatigue, and 2-h postpartum fatigue than those of the control group (p < 0.05). CONCLUSIONS: Continuous epidural block combined with free positions can significantly shorten the duration of labor, reduce the incidence rate of genital tract injuries, increase the sense of control during childbirth, and ease the fear of childbirth and postpartum fatigue.
Malska M, Malczak P, Waledziak M
… +9 more, Kupczyk W, Dowgiallo-Gornowicz N, Rozanska-Waledziak A, Franczak P, Katkowski B, Szymanski M, Wysocki M, Lewandowski M, Major P
Ginekol Pol
· 2025 Oct · PMID 41084364
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OBJECTIVES: Obesity negatively affects female fertility and pregnancy outcomes. Bariatric surgery improves weight, metabolism, and fertility, but concerns remain about maternal and neonatal outcomes. To evaluate reproduc...OBJECTIVES: Obesity negatively affects female fertility and pregnancy outcomes. Bariatric surgery improves weight, metabolism, and fertility, but concerns remain about maternal and neonatal outcomes. To evaluate reproductive and perinatal outcomes in Polish women who conceived after bariatric surgery (MOMBARIS 2). MATERIAL AND METHODS: A retrospective study (2015-2024) in 11 bariatric centers included 160 women post-surgery; 154 conceived and were analyzed for fertility, pregnancy, and neonatal outcomes. RESULTS: Pregnancy occurred in 97.5% of participants, mostly spontaneous (83.8%) and planned (58.7%). BMI dropped from 43.1 to 30.45 kg/m². COMPLICATIONS: anemia (35.9%), gestational diabetes (16.2%), hypertension (10.2%). Cesarean rate: 52.7%. Neonatal outcomes were favorable: median birth weight 3,330 g, gestational age 39 weeks, 97.9% had Apgar 10, and 3.0% had anomalies. CONCLUSIONS: Despite maternal risks, neonatal outcomes were excellent. Bariatric surgery improves fertility without compromising fetal health.
Ginekol Pol
· 2025 Oct · PMID 41041853
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OBJECTIVES: This article aimed to systematically review the literature on smooth muscle tumors of uncertain malignant potential, known as STUMPs. These tumors pose both diagnostic and therapeutic challenges. MATERIAL AND...OBJECTIVES: This article aimed to systematically review the literature on smooth muscle tumors of uncertain malignant potential, known as STUMPs. These tumors pose both diagnostic and therapeutic challenges. MATERIAL AND METHODS: A literature search was conducted in PubMed using the keyword STUMP, covering articles from the last 5 years. Relevant articles were retrieved in full format and reviewed for additional references, from which further eligible articles were also included RESULTS: STUMPs often resemble leiomyomas or leiomyosarcomas. While they typically have a benign course, some patients may experience recurrence and distant metastasis. There are no standardized guidelines for treatment; however, hysterectomy is commonly performed, or myomectomy may be considered to preserve fertility. CONCLUSIONS: The findings highlight the necessity for additional studies to standardize the diagnosis and treatment of these tumors. Continuous monitoring of patients post-surgery is essential to identify any recurrence or metastasis.
OBJECTIVES: The French Ambulatory Cesarean Section (FAUCS) is an extraperitoneal cesarean technique aimed at enhancing maternal recovery and reducing postoperative morbidity. While early trials suggest certain benefits o...OBJECTIVES: The French Ambulatory Cesarean Section (FAUCS) is an extraperitoneal cesarean technique aimed at enhancing maternal recovery and reducing postoperative morbidity. While early trials suggest certain benefits over conventional cesarean section (CS), real-world data remains scarce. This study compares maternal and neonatal outcomes between FAUCS and CS in a prospective cohort, with emphasis on perioperative recovery. MATERIAL AND METHODS: This prospective study included women undergoing elective cesarean section (FAUCS or CS) at term (37-40 Hbd) between September 2023 and December 2024. Maternal outcomes included surgery duration, blood loss, time to mobilization, food oral intake, and initiation of breastfeeding. Neonatal outcomes included birth weight, Apgar scores, and umbilical cord arterial pH. Comparisons used t-tests, Wilcoxon tests, or Chi-square tests (p < 0.05; analysis in R). RESULTS: Sixty-six patients were included (FAUCS: 30; CS: 36). Baseline maternal or obstetric characteristics were comparable. No differences were found in gestational age or birthweight. FAUCS neonates had marginally lower umbilical pH (7.33 ± 0.07 vs 7.36 ± 0.06, p = 0.009). No difference was found in Apgar scores. FAUCS was associated with longer surgery (30.7 ± 4.1 min vs 26.4 ± 10.3 min, p = 0.006), but significantly faster mobilization, food oral intake, and breastfeeding (all p < 0.001). Fundal pressure was used less often (p < 0.001), and instrumental assistance more frequently (p < 0.001) in FACUS. The use of weak opioids was also lower (p = 0.036). The hospital stay was similar. CONCLUSIONS: FAUCS appears to enhance early recovery without compromising maternal or neonatal outcomes, supporting its use in select patients.
OBJECTIVES: This study aims to present the postoperative results of patients who underwent a hysteroscopic isthmocele resection, identify factors affecting patients who experienced surgical failure, and develop a new tre...OBJECTIVES: This study aims to present the postoperative results of patients who underwent a hysteroscopic isthmocele resection, identify factors affecting patients who experienced surgical failure, and develop a new treatment algorithm for managing an isthmoceles, whose treatment remains unclear. MATERIAL AND METHODS: The hospital records of women who underwent hysteroscopic istmocele resection due to postmenstrual spot-bleeding at a tertiary central university hospital were examined. The patients were divided into two groups: successful surgery (Group 1) and unsuccessful surgery (Group 2) after hysteroscopic isthmocele resection. To evaluate the results of unsuccessful surgery in patients with failed hysteroscopic isthmocele resection, the number of caesarean sections, BMI and isthmocele area were considered as candidate predictors. RESULTS: During the study period, 53 patients who met the inclusion criteria and underwent hysteroscopic isthmocele resection were evaluated. Surgical success was detected in 34 patients (64.1%), while unsuccessful surgery was detected in 19 patients (35.9%). In the ROC analysis performed to predict an unsuccessful surgery, AUC was detected as 0.717, sensitivity was 79%, specificity was 68% and p value was 0.009 in patients with a BMI > 27.5. In patients with previous caesarean sections, the number > 2.5; AUC was 0.765, sensitivity was 58%, specificity was 91% and p value was 0.002 in the receiver operating characteristic (ROC) analysis. In patients with isthmocele area > 23.5 mm2, AUC was 0.781, sensitivity was 63%, specificity was 91% and p value was 0.001 in the ROC analysis. In the multivariate regression analysis, the effect of the isthmocele area in predicting unsuccessful surgery was determined to be a statistically significant independent variable (OR: 1.239, 95% CI: 1.050-1.462, p = 0.011). CONCLUSIONS: Although a hysteroscopic isthmocele resection is recommended for patients with an RMT over 3 mm, certain factors increase the risk of surgical failure. If an isthmocele area exceeds 23.5 mm², the number of previous caesarean sections is three or more or a person's BMI is 27.5 or higher, the risk of unsuccessful hysteroscopic surgery is high. In these patients, isthmocele repair should be performed via the laparoscopy, laparotomy or vaginal approach.
OBJECTIVES: Large for gestational age (LGA) is defined as a birth weight equal to or higher than the 90th centile for a certain gestational age. Despite the efforts to optimize therapeutic goals to stabilize diabetes, th...OBJECTIVES: Large for gestational age (LGA) is defined as a birth weight equal to or higher than the 90th centile for a certain gestational age. Despite the efforts to optimize therapeutic goals to stabilize diabetes, there is still a high rate of LGA in type 1 diabetes mellitus (T1DM) mothers. The aim of this paper is a literature review of the data on predictors of LGA incidence in pregnancies complicated by type 1 diabetes mellitus. RESULTS: Potential LGA predictors in pregestational diabetes include glucose concentration during pregnancy, maternal age, diabetes duration, increased body weight both at the beginning of gestation and at the time of delivery, as well as the weight gain in pregnancy. LGA risk is also associated with the use of an insulin pump (CSII), especially without the support of a continuous glucose monitoring system (CGMS). Significant glycaemic control parameters among others include average fasting glycaemia in the 3rd trimester, HbA1c in the 1st and 3rd trimesters, and among CGMS parameters - shorter TIR (time in range), shorter TBR (time below range) in the 2nd and 3rd trimesters, longer TAR (time above range) > 140 and average glycaemia in each trimester of gestation. CONCLUSIONS: There is still a need for identification of new predictors and theraputic goals in pregnancy in T1DM women to reduce the prevalence of LGA newborns.
OBJECTIVES: Fetal echocardiography (FE) is a critical diagnostic tool for assessing cardiac and extracardiac abnormalities in high-risk pregnancies. In this paper we evaluate indications and findings of FE in a high-risk...OBJECTIVES: Fetal echocardiography (FE) is a critical diagnostic tool for assessing cardiac and extracardiac abnormalities in high-risk pregnancies. In this paper we evaluate indications and findings of FE in a high-risk cohort at a Polish fetal echocardiography clinic. MATERIAL AND METHODS: This retrospective, observational cohort study included 991 patients undergoing FE between January 2023 and December 2024. A single prenatal cardiologist with extensive FE experience performed all examinations. Indications and findings were analyzed, with results categorized into subgroups. RESULTS: Mean maternal age was 31.6 years (SD 5.3), with a median gestational age of 26 weeks (IQR = 4). The most frequent indications were intermediate risk of chromosomal aberrations from first-trimester screening (17.76%), intra-cardiac echogenic foci (13.32%), and elevated risk of chromosomal aberrations (12.82%), comprising 43.69% of referrals. Normal FE results were observed in 88.49% of cases (n = 877). Abnormalities (cardiac or extracardiac) occurred in 11.51%, with cardiac abnormalities in 7.16% (71 cases: 3.12% structural, 4.03% functional). Ventricular septal defect (1%) and arrhythmias (1.31%) were the most common structural and functional findings, respectively. Extracardiac abnormalities with normal cardiac imaging occurred in 4.3%. No significant differences in abnormality prevalence were found between high/intermediate chromosomal risk groups and the cohort (odds ratios: 0.47-1.14). CONCLUSIONS: First-trimester screening results and soft markers predominantly drove FE referrals. The 11.51% abnormality rate underscores the importance of FE in high-risk pregnancies, despite no significant association with chromosomal risk levels.
Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is an emerging minimally invasive technique that combines natural orifice access with endoscopic visualization and instrumentation. Minimally invasive surg...Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is an emerging minimally invasive technique that combines natural orifice access with endoscopic visualization and instrumentation. Minimally invasive surgery has revolutionized gynecologic practice by reducing postoperative morbidity and enhancing recovery. vNOTES represents a novel advancement, utilizing the vaginal route to access the peritoneal cavity without abdominal incisions. This technique offers potential benefits including scarless surgery, decreased postoperative pain, and shortened hospital stays. This review summarizes the surgical technique, clinical applications, advantages, limitations, and future perspectives of vNOTES in gynecologic surgery.
OBJECTIVES: In recent years, advances in prenatal diagnostics have enabled the identification of congenital abnormalities, including genetically determined disorders, at an early stage of fetal development. Diagnosing a...OBJECTIVES: In recent years, advances in prenatal diagnostics have enabled the identification of congenital abnormalities, including genetically determined disorders, at an early stage of fetal development. Diagnosing a lethal fetal anomaly affects the entire family and is often a traumatic experience for the parents. Perinatal palliative care provided by perinatal hospice is a model of specialized care for families following the prenatal diagnosis of a lethal fetal condition. MATERIAL AND METHODS: After ten years of operation, we analyzed the perinatal palliative care protocol implemented in the Hospital of the Brothers Hospitallers in Katowice, a part of Bonifratres Medical Centre. RESULTS: We aimed to present the model of perinatal and postnatal care developed at the hospital for families receiving such support in the Silesian agglomeration. CONCLUSIONS: We also wanted to show the importance of perinatal palliative care provided by one team from the prenatal period through delivery until the child's death or until the pediatric hospice provides the care of the child.
OBJECTIVES: Activating positive coping strategies for cancer in the face of a new, changed health situation, good acceptance of the illness, life satisfaction, and dispositional optimism influence the quality of life of...OBJECTIVES: Activating positive coping strategies for cancer in the face of a new, changed health situation, good acceptance of the illness, life satisfaction, and dispositional optimism influence the quality of life of patients and are key factors important in the healing process. MATERIAL AND METHODS: The study was conducted among 101 women diagnosed with cervical cancer. The research took place between 2023 and 2024. The diagnostic survey method was used, along with the following research tools: an original questionnaire, the Acceptance of Illness Scale (AIS), the Satisfaction with Life Scale (SWLS), the Life Orientation Test-Revised (LOT-R), and the Mini-Mental Adjustment to Cancer Scale (Mini-MAC). RESULTS: Sperman correlation analysis showed that LOT-R, SWLS and AIS significantly (p < 0.05) and negatively (r < 0) correlate with three Mini-MAC coping strategies: anxious preoccupation, helplessness-hopelessness, and destructive style. This means that higher levels of these strategies are associated with lower levels of dispositional optimism, life satisfaction, and acceptance of illness. Additionally, LOT-R, SWLS, and AIS significantly (p < 0.05) and positively (r > 0) correlate with two Mini-MAC strategies: fighting spirit and constructive style. Thus, higher levels of these adaptive coping strategies correspond to higher levels of optimism, life satisfaction, and illness acceptance. CONCLUSIONS: The most chosen style by the patients was the constructive style, as opposed to the destructive style, which promotes acceptance of illness, life satisfaction, and dispositional optimism. The determinants influencing acceptance of illness, life satisfaction, and optimism, as well as adaptation to cancer, were age, place of residence, duration of illness, and type of procedure performed.
Rybak-Krzyszkowska M, Stopyra L, Jaczynska R
… +12 more, Swiatkowska-Freund M, Borowski D, Czech-Kowalska J, Czuba B, Grzesiak M, Kwiatkowski S, Marczynska M, Pawlowska M, Przyslo L, Sieroszewski P, Tomasiewicz K, Wielgos M
OBJECTIVES: The aim of our study is to evaluate the effect of pathogens in the vaginal flora on preterm birth in pregnant women with short cervical length. MATERIAL AND METHODS: In our study, 418 patients with asymptomat...OBJECTIVES: The aim of our study is to evaluate the effect of pathogens in the vaginal flora on preterm birth in pregnant women with short cervical length. MATERIAL AND METHODS: In our study, 418 patients with asymptomatic cervical shortening in the second and third trimesters of pregnancy were evaluated retrospectively. Clinical data such as age, cervical length measurement, gestational age at hospital admission and delivery, and vaginal microbiological findings were evaluated for all patients. RESULTS: The bacterial spectrum in the vagina revealed seven different bacterial taxa. The most common bacteria were Ureaplasma spp. and Mycoplasma spp. However, cases of Ureaplasma spp., Mycoplasma spp. and E.Coli taxa were also detected together. In 418 patients included, bacterial colonization was seen in 283 and not in 135. In women who delivered preterm before and after 34 weeks, the most common bacteria was Ureaplasma spp. However, the prevalence of these bacterial taxa was not significantly different between those who delivered preterm and those who did not. CONCLUSIONS: Our study provides a general idea about vaginal bacterial colonization and its possible effects in pregnant women with short cervical length. The clinical significance of vaginal bacterial colonization on preterm labor remains unclear and up-to-date.
OBJECTIVES: The study aimed to evaluate the efficacy of hormone treatment, barrier gel and their combined application following hysteroscopic metroplasty in women with septate (U2) and T-shaped uteri (U1a). MATERIAL AND...OBJECTIVES: The study aimed to evaluate the efficacy of hormone treatment, barrier gel and their combined application following hysteroscopic metroplasty in women with septate (U2) and T-shaped uteri (U1a). MATERIAL AND METHODS: Hysteroscopic uterine septum resection was performed in 236 patients with U2, while lateral metroplasty was conducted in 191 patients with U1a. After surgery, 56 women with U2 and 58 women with U1a received hormone therapy (HT). Cross-linked hyaluronic acid (cHA) gel was applied to 54 women with U2 and 37 with U1a. Combined therapy (CT) using both HT and cHA gel was implemented for 48 women with U2 and 33 with U1a. Postoperative treatment was not performed in corresponding control groups. Reproductive outcomes were evaluated within 18 ± 6 months postoperatively. RESULTS: Compared to the control group, the clinical pregnancy rate was significantly higher in the U2-HT, U2-cHA and U2-CT groups, as well as in the U1a-HT and U1a-CT groups (p < 0.05). The miscarriage rate was significantly lower in the U2-cHA and U2-CT groups (p < 0.05). The live birth rate was significantly higher in the U2-cHA and U2-CT groups (p < 0.05). A second-look hysteroscopy revealed intrauterine adhesions in U2-HT (9%) and its respective control group (33%), as well as in the U1a control group (18%). CONCLUSIONS: Hysteroscopic metroplasty enhances reproductive outcomes in women with septate and T-shaped uteri. Postoperative treatment is necessary to prevent the development of intrauterine adhesions.