{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:17:33Z","timestamp":1790878653224,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Second\u2010look hysteroscopy is proposed after hysteroscopic metroplasty to assess healing, identify residual septa or intrauterine adhesions (IUAs), and optimize reproductive outcomes. However, its timing, indications, and clinical utility remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the role of second\u2010look hysteroscopy after metroplasty for septate uterus, focusing on the incidence of residual septum and IUAs, reproductive outcomes, and preferred timing and indications for follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Scopus, Web of Science, and Cochrane CENTRAL (from inception to March 2025) was conducted using terms related to \u201csecond\u2010look hysteroscopy\u201d and \u201cseptate uterus.\u201d Reference lists of included articles were also screened manually.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>Studies reporting on women with a diagnosis of septate uterus who underwent hysteroscopic metroplasty followed by second\u2010look hysteroscopy were included. Eligible designs were randomized controlled trials (RCTs), cohort studies, cross\u2010sectional studies, case series, and case reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>Two independent reviewers extracted data on study characteristics, surgical approach, second\u2010look findings, reproductive outcomes, and timing between procedures. The Joanna Briggs Institute tools were used to assess methodological quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>A total of 15 studies involving 1409 women undergoing metroplasty were included. Among them, 933 (66.2%) underwent second\u2010look hysteroscopy at a mean of 10\u2009weeks (range: 4\u201320). Residual septa \u22651\u2009cm were found in 2.6% of cases. IUAs were reported in 1%\u201335% of patients but fell below 10% in studies using antiadhesion barriers. Reproductive outcomes were reported for 637 women actively trying to conceive: 422 pregnancies (66.2%), a live birth rate of 56.2%, and a pregnancy loss rate of 9.6%. Selective use of three\u2010dimensional (3D) sonohysterography showed high diagnostic concordance with hysteroscopy, potentially reducing the need for routine invasive follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Second\u2010look hysteroscopy provides diagnostic and therapeutic value, particularly in patients at risk for residual septum or IUAs. Its selective use, combined with adjunctive tools such as 3D imaging and adhesion barriers, may improve outcomes while avoiding unnecessary procedures. High\u2010quality prospective trials are needed to better define timing and patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70733","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T09:37:11Z","timestamp":1765791431000},"page":"1232-1243","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Second\u2010look hysteroscopy after metroplasty for uterine septum: Shedding light on an overlooked step\u2014A systematic review"],"prefix":"10.1002","volume":"173","author":[{"given":"Salvatore Giovanni","family":"Vitale","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties University of Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1022-0958","authenticated-orcid":false,"given":"Stefania","family":"Saponara","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences University of Cagliari  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Chieppa","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences University of Cagliari  Cagliari Italy"},{"name":"Department of Surgical Sciences Gynecology and Obstetrics 1, A.O.U. 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