P11.08: Three-dimensional ultrasound in diagnosis of septate uterus in patients with suspected congenital uterine anomalies

2010 ◽  
Vol 36 (S1) ◽  
pp. 210-210
Author(s):  
B. Graupera ◽  
M. Pascual ◽  
B. Úbeda ◽  
L. Hereter ◽  
C. Pedrero ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Septate Uterus ◽  
Uterine Anomalies

scholarly journals The Role of Three-dimensional Ultrasound in the Assessment of Congenital Uterine Anomalies

2012 ◽  
Vol 6 (4) ◽  
pp. 415-423
Author(s):  
Sarah Tabi
Keyword(s):  
Three Dimensional ◽  
3D Ultrasound ◽  
Ultrasound Images ◽  
Septate Uterus ◽  
Saline Infusion Sonography ◽  
Unicornuate Uterus ◽  
Uterine Anomalies ◽  
Different Types ◽  
2D Ultrasound

ABSTRACT Three-dimensional (3D), two-dimensional (2D) ultrasound and saline infusion sonography (SIS) are beneficial tools in diagnosing congenital uterine anomalies. This article illustrates six various case scenarios based on 3D ultrasound images in order to review the concepts of ultrasound diagnosis of congenital uterine anomalies and apply it to the presented case studies. These cases scenarios educate the reader on arcuate uterus, septate uterus, bicornuate uterus, didelphic uterus, uterus duplex and unicornuate uterus. This article also presents the sequence of embryologic events leading to the congenital uterine anomalies. The role of 3D ultrasound in diagnosis and treatment of congenital uterine anomalies is presented, along with its advantages over 2D ultrasound, SIS, X-ray hysterosalpingography, magnetic resonance imaging, hysteroscopy and laparoscopy. The effects of hysteroscopic metroplasty on fertility are also illustrated and discussed. After this case-based discussion is completed, the readers will be able to make a differential diagnosis of the different types of congenital uterine anomalies. How to cite this article Tabi S, Kupesic Plavsic S. The Role of Three-dimensional Ultrasound in the Assessment of Congenital Uterine Anomalies. Donald School J Ultrasound Obstet Gynecol 2012;6(4):415-423.

scholarly journals Diagnostic Accuracy of Three-dimensional Ultrasonography in Detection of Endometrial Lesions compared with Hysteroscopy in Infertile Women

2016 ◽  
Vol 10 (4) ◽  
pp. 393-397
Author(s):  
Firoozeh Ahmadi ◽  
Farnaz Akhbari ◽  
Fatemeh Niknejad ◽  
Hadieh Haghighi ◽  
Zahra Ghahremani ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Gold Standard ◽  
Three Dimensional ◽  
Assessment Method ◽  
Diagnostic Efficiency ◽  
Infertile Women ◽  
Reliable Assessment ◽  
Uterine Anomalies

ABSTRACT Introduction Two of the most frequent procedures performed on infertile women are two-dimensional ultrasound (2DUS) and three-dimensional ultrasound (3DUS). Hysteroscopy is considered as the gold standard for evaluation of acquired endometrial lesions in infertile women; however, 3DUS is used as a noninvasive, less expensive, and reliable assessment method for evaluation of the intrauterine lesions in infertile women. We aimed to compare the diagnostic efficiency between 3DUS and hysteroscopy in the detection of lesions (polyps, submucous leiomyoma, and synechiae) in infertile women. Materials and methods In this prospective observational study, infertile women (n = 155) with indication of hysteroscopy were scheduled to undergo 3DUS prior to hysteroscopy from September 2010 to 2011. Women with suspected congenital uterine anomalies were excluded. The sensitivity and specificity values of 3DUS were compared with those of hysteroscopy. Hysteroscopy was used as the gold standard for diagnosis of intrauterine lesions in infertile women. Results Of the 155 women, 50 were found to have an intracavitary abnormality, 36 had polyps, 12 had myomas, and 7 had synechiae on hysteroscopic findings. Examination with 3DUS in the diagnosis of intrauterine lesions reached an accuracy of 94%, and 92.15 and 96.9% of sensitivity and specificity respectively. Positive predictive value (PPV) was 83.9%, and a negative predictive value (NPV) was 91.3% (LR+ = 10.75, LR+ = 0.065). Conclusion According to our results, 3DUS has a reliable diagnostic accuracy for intrauterine lesions, and it may limit unnecessary hysteroscopy in patients with normal results. How to cite this article Ahmadi F, Haghighi H, Ghahremani Z, Niknejad F, Akhbari F, Ramezanali F, Chehrazi M. Diagnostic Accuracy of Three-dimensional Ultrasonography in Detection of Endometrial Lesions compared with Hysteroscopy in Infertile Women. Donald School J Ultrasound Obstet Gynecol 2016;10(4):393-397.

P–747 Implementation of the ESHRE Congenital uterine anomaly classification into practice and clinical pregnancy outcomes at a Tertiary University Teaching Hospital Fertility department

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Samanta ◽  
L Lacey ◽  
M Isdale ◽  
M Akhtar
Keyword(s):  
Conservative Management ◽  
Surgical Intervention ◽  
Recurrent Miscarriage ◽  
Clinical Pregnancy ◽  
University Teaching ◽  
Ultrasound Scan ◽  
Septate Uterus ◽  
Patient Counselling ◽  
Uterine Anomalies ◽  
History Of

Abstract Study question What’s the incidence of class U1-U6 CUAs in subfertile women? What’s the clinical pregnancy rate in women with the most common anomaly, a septate uterus? Summary answer The incidence of CUAs is 5.9% in our subfertile population, with a septate uterus (U2) being the most common abnormality in 4.2% of the population What is known already Congenital uterine anomalies (CUAs) are common. A systematic review suggested an estimated overall prevalence of 5.5% in an unselected population, 8.8% in the subfertile population, 13.3% in those with a history of recurrent miscarriage and 24.5% in those with a history of subfertility and recurrent miscarriage. A septate uterus (U2) is the most common CUA and is amenable to surgical intervention although at present there is a lack of evidence suggesting benefit in subfertile patients. Women with a septate uterus are known to have poorer reproductive outcomes, including reduced conception rate and increased first trimester loss. Study design, size, duration All patients referred to our department for subfertility had a 2D pelvic ultrasound scan as part of their baseline investigations. Since it was established in 2016, all patients with a suspected CUA based on clinical history and investigations, were referred to the clinic and data collected prospectively. Prior to this, women with suspected CUAs required a hysteroscopy or MRI scan for confirmation of diagnosis, often leading to long waiting lists and treatment delays. Participants/materials, setting, methods Out of the 4716 patients referred to the department for subfertility from 2016–2018, 302 women were referred to the 3D clinic due to suspicion of a CUA. Transvaginal 3D-ultrasound scan was performed and CUAs classified according to the ESHRE/ESGE working groups. Patients diagnosed with a septate uterus were given options of conservative versus surgical treatment, in the light of unclear benefits of hysteroscopic septum resection. Clinical pregnancy data were collected about this cohort. Main results and the role of chance Of the 302 women referred to the service, the uteri of 25 patients were unable to be assessed accurately, most commonly as the cavity was unclear due to a thin endometrium. The remaining 277 patients were classified as having the following CUAs; Normal (U0) 63 patients, Dysmorphic (U1) 5 patients, Septate (U2) 199 patients, Bicorporeal (U3) 6 patients and Hemi uterus (U4) 4 patients. No women were classified as having an aplastic uterus (U5) or unclassified (U6). Of the 199 women with a septate uterus, 15 women opted for surgical intervention, 143 women decided to have conservative management and 41 women were lost to follow up. The women who had hysteroscopic resection of the septum had a mean age of 35 years, 6/15 had primary subfertility and 6/15 had a history of recurrent miscarriage. The women who had conservative management had a mean age of 32.5 years, 100/143 had primary subfertility and 20/143 had a history of recurrent miscarriage. At present, 89/143 women who have had conservative management and 12/15 women who had surgical interventions have had a clinical pregnancy, 72/89 and 6/12 of these pregnancies were IVF/ICSI pregnancies respectively. Limitations, reasons for caution This is an observational study, these findings can be useful for patient counselling. However, ideally randomised controlled trials are needed as evidence for the different treatment options for the cohort of patients with septate uterus, which are largely lacking in the current literature, as their feasibility remains a challenge. Wider implications of the findings: Three-dimensional transvaginal ultrasonography clinics are cost-effective one-stop services, successfully providing a diagnosis and management plan in 92% of patients referred with a suspected CUA. They increase patient satisfaction by providing an opportunity to discuss risks in future pregnancies and reducing reliance on hysteroscopy and MRI scans. Trial registration number Not applicable

Study of the Vascularity of Uterine Septum Using Three Dimensional Power Doppler Ultrasound

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M I M Amer ◽  
N E Hassan ◽  
M E Ahmed ◽  
H M M Elnaggar
Keyword(s):  
Doppler Ultrasound ◽  
Power Doppler ◽  
Adhesion Formation ◽  
Recurrent Abortion ◽  
Power Doppler Ultrasound ◽  
Septate Uterus ◽  
3D Power Doppler ◽  
Uterine Anomalies ◽  
Significant Difference ◽  
Uterine Septum

Abstract Background Uterine anomalies are a relatively common congenital abnormality, with uterine septum being the most common. This is even truer in patients with recurrent pregnancy loss, in whom rates of uterine abnormalities may approach 15% to 27%. Historically, the uterine septum has been approached via laparotomy through either a Tompkins or Jones procedure. These successful, but highly morbid, procedures require laparotomy with significant hospital stays, subsequent cesarean delivery, and have carried a high risk of adhesion formation. More recently, this surgery has been supplanted by hysteroscopy or other minimally invasive methodologies. Objective To assess the relation between the vascularity of uterine septum and obstetric performance with Transvaginal 3D Power Doppler Ultrasound. Patients and Methods Early Cancer Detection Unit and Ultrasound and Fetal special care Unit in Ain Shams University Maternity Hospital (ASUMH). Recruitment took place between May 2017 and November 2018. Cross-sectional study. The study included 30 cases of women with uterine septum. Intervention: Transvaginal 3D power Doppler ultrasound was done to all cases with septal volume and vascularity assessment using VOCAL system and Histogram facility. The study included 30 patients with septate uterus, twelve of them suffered from 1ry infertility while the other eighteen suffered from recurrent abortion. Results There was statistical significant difference between the two groups regarding vascularity (VI, FI, and VFI) of septum (P < 0.05). Conclusion The vascularity of septate uterus is variable. The power Doppler indices shows that septate uterus in cases with recurrent abortion is highly vascular while in cases with 1ry infertility shows low vascularity. Highly vascular septum may be a site of implantation which may be a cause of recurrent abortion thus; excision of the septum may help prevent recurrent abortion, while low vascular septum may prevent implantation which may be a cause of infertility thus; incision of the septum may help in treatment of infertility. Correlation with histopathologic features of septum may be required to decide the best management of the septum.

scholarly journals Should Diagnostic Hysteroscopy be a Routine Procedure During Diagnostic Laparoscopy in Infertile Women?

2008 ◽  
Vol 8 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Zulfo Godinjak ◽  
Edin Idrizbegović
Keyword(s):  
Diagnostic Laparoscopy ◽  
Diagnostic Tools ◽  
Routine Procedure ◽  
Endometrial Polyps ◽  
Septate Uterus ◽  
Infertile Women ◽  
Uterine Anomalies ◽  
Diagnostic Hysteroscopy ◽  
Infertile Patients

The aim of this study was to clarify the role of simultaneous combined diagnostic approach using laparoscopy and hysteroscopy in the evaluation of female infertility.In a retrospective study, 360 infertile women underwent complete fertility evaluation. All the patients were examined by simultaneous combined laparoscopy and hysteroscopy as a part of the routine infertility evaluation.Laparoscopy and hysteroscopy were successful in 360 patients. Bilateral tubes were blocked in 18 (5%) and unilateral tubal occlusion were in 30 (8,33%) of patients. Pelvic adhesions were revealed in 40 (11,11%), and myomas in 42 (11,65%) out of that 31 (8,6%) were revealed by laparoscopy and 11 (3,05%) by hysteroscopy. Endometrial polyps were revealed in 26 (7,22%) and Syndrome Asherman in 3(0,83%) of patients. Uterine anomaly was found in 19 (5,27%) of cases and out of that septate uterus in 7 (37,15%), bicornuate uterus in 5 (26,31%), arcuate uterus in 4 (21,26%) and uterus unicornu cum cornu rudimentario in 3 (15,27%) of uterine anomalies. Endometriosis was found in 51 (14,16%), dermoid cysts in 8 (2,22%) and in 16 (4,44%) functional cysts of patients. Also, Fitz-Hugh- Curtis syndrome was revealed in 23 (6,11%) of our patients.Laparoscopy and hysteroscopy play very important role as diagnostic tools in the infertility women. Combined diagnostic simultaneous laparoscopy and hysteroscopy should be performed in all infertile patients before the treatment.

scholarly journals OP19.05: Three dimensional echographic evaluation of septate uterus after hysteroscopic septum resection and correlation with pregnancy outcome

2011 ◽  
Vol 38 (S1) ◽  
pp. 111-112
Author(s):  
C. Ionescu ◽  
D. Gheorghiu ◽  
I. Pacu ◽  
B. Davitoiu ◽  
M. Dimitriu
Keyword(s):  
Pregnancy Outcome ◽  
Three Dimensional ◽  
Septate Uterus

Three-dimensional ultrasound in the diagnosis and the classification of congenital uterine anomalies using the ESHRE/ESGE classification: a diagnostic accuracy study

2019 ◽  
Vol 299 (3) ◽  
pp. 779-789 ◽  
Author(s):  
Anna Kougioumtsidou ◽  
Themistoklis Mikos ◽  
Grigoris F. Grimbizis ◽  
Aikaterini Karavida ◽  
Theodoros D. Theodoridis ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Three Dimensional ◽  
Diagnostic Accuracy Study ◽  
Uterine Anomalies ◽  
Accuracy Study
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