الفهرس 
Patient and Methods
The vaginoscopic approachOnly 14 pages are availabe for public view
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Abstract
Office hysteroscopic examination is now an
established step in the diagnostic work up of cases with
abnormal uterine bleeding, infertility, and recurrent
miscarriage that can be performed safely and efficiently
without anesthesia in most cases.
Hysteroscopy offers great assistance for the
interpretation of uncertain findings from other diagnostic
methods. Furthermore, it enables direct visualization of
cervical canal, uterine cavity and increase the precision and
accuracy in the diagnosis of intrauterine abnormalities.
This study was conducted at Ain Shams University
Maternity Hospital from May 2014 to February 2015 after
informed written consent which was obtained from each
participate for inclusion in this study.
The aim of this study was the assessment of the
prevalence and types of uterine defects in patients with
recurrent pregnancy loss (RPL) through hysteroscopy.
This study included one hundred and twenty non
pregnant patients with history of two or more consecutive
unexplained first and second trimester abortion before 20
weeks.On admission, every patient was subjected to
detailed history and all patients had normal complete blood
count, urine analysis, lupus anticoagulant and
anticardiolipin antibodies were negative, all of the partners
had a normal semen analysis and exclusion of patient with
genital tract cancer (cervical or uterine), active pelvic
infection, viable intrauterine pregnancy.
Regarding to the results of this study the mean age
was 295.8 the median no previous abortion was 3(2-4)
with 75.8% of this was first trimesteric abortion. The
median no of previous deliveries was 1(0-2) and
hysteroscopic finding was 60.8% of patients had normal
finding and 36.7% had single hysteroscopic abnormality
and 2.5% had two abnormality we also found that the most
common hysterosopic abnormality was uterine adhesion
12.5% of all abnormality and all of this patients had
adhesiolysis, then uterine septum 10% of patients, 5% of
them had uterine septoplasty and 1 case had uterine septum
excision and the least hysteroscopic abnormality was
cervical polyp 1 patient (0.8%).
The study found that no statistically significant
difference between patients with normal hysteroscopic
finding and patients with abnormal hysteroscopic finding as regard age, number of previous abortion, number of
previous deliveries, mode of delivery NVD or C.S.
But there was statistically significant as regard
timing of abortion, history of hypomenorrhea or abnormal
uterine bleeding as associated symptom with recurrent
abortion.
By using multivariable binary logistic regression
model for predictors of abnormal hysterosopic finding it
was found that abnormal uterine bleeding if associated with
patients recurrent miscarriage it gives a high suspection for
structural uterine abnormalities (SUAs) in this patients if
hysterosopcy done.
from the above, its concluded that SUAs were
detected in nearly 39.2% of patient with recurrent
miscarriages, hysteroscopy has much to offer in the
diagnosis of SUAs, for this reason it should be
systematically assessed in patients with a history of
recurrent miscarriage.
Because uterine anomalies are the most treatable
causes of recurrent miscarriage, further studies are
recommended for assessment of the role of hysteroscopic
surgical correction of uterine anomalies on pregnancy
outcome.