Case report of unicornuate uterus with subfertility

Most often the uterine developmental anomalies are missed until later in life presenting as infertility. This case report is of a couple presented with primary infertility of six years. 3D ultrasonography helps in for clinical suspicion of a uterine anomaly. The wife had a left unicornuate uterus with adequate uterine cavity and right rudimentary horn and also poor ovarian reserve. The husband had astheno-teratozoospermia. After a failed IVF frozen embryo transfer the couple were advised and underwent IVF-ICSI of donor oocytes with husband sperm. One 5AB blastocyst transferred and at 5 weeks and 6 weeks scans gestational sac along with yolk sac and foetal heart pulsations were noted, respectively. Single embryo transfer with good quality blastocyst is preferable for a unicornuate uterus since there is a risk of pre term labour.

PREVALENCE AND DIAGNOSIS OF MULLERIAN ANOMALIES IN INFERTILE WOMEN USING DIFFERENT MODALITIES

Objective: To diagnose the various types of Mullerian abnormalities using different modalities and to nd out its prevalence among infertile women. Method: A prospective study was conducted on 200 infertile women attending the outpatient and inpatient department of Obstetrics and Gynaecology in Swaroop Rani Nehru hospital and kamla Nehru Hospital of MLN medical College,Prayagraj during the year 2019-2020. Hysterosalpingography, 3 D ultrasonography and hysterolaparoscopy was used as diagnostic modalities to nd the prevalence of mullerian anomalies among infertile women of age group of 20 to 40 years. A total of 18 cases (9%) Results: were diagnosed to have mullerian anomalies which included 7 cases of partial septate uterus(3.5%), 2 cases (1%) each of complete septate,partial bicornuate and arcuate uterus respectively, 1 case(0.5%) each of agenesis, didelphys, complete bicornuate,unicornuate-non communicant and unicornuate without horn respectively. Conclusion: Prevalence of Mullerian anomalies in our study was 9% among infertile women, partial septate being the most common. Diagnostic hysterolaparoscopy was best investigation(sensitivity=100%, specicity=100%,PPV=100%,NPV=100%). 3D ultrasonography ,being non-invasive and more convenient was stongly comparable to hysterolaparoscopy( kappa value=0.906) than to hysterosalpingography( kappa value=0.660).

Prediction of chronic endometritis using 2D and 3D transvaginal ultrasound examination in infertile women

Background: Chronic endometritis is a pathology of continuous and hidden inflammatory process characterized by the infiltration of plasma cells into the endometrial stroma. Transvaginal bi-dimensional ultrasonography is in need to be evaluated in prediction of chronic endometritis in women with delayed pregnancy or infertility as a non-invasive, cheap, acceptable, and safe tool of diagnosis. Previously, 3D ultrasonography had been described as a novel for diagnosis of chronic endometritis and correlation of the images with hysteroscopic view results. Objectives were to predict the presence of chronic endometritis in infertile women during their reproductive age through examination of the uterine cavity by 2D and 3D transvaginal sonography to elicit proposed ultrasonographic signs of endometritis.Methods: This observational prospective study took place at Shatby university hospital, Alexanderia universtiy and was done on two hundred infertile women. Women were assigned for ultrasonographic evaluation as a part of pre-treatment assessment. Detailed history was taken from all the patients included in the study. General examination and routine laboratory investigations were done according to hospital protocol. All patients were asked to do ultrasound examination immediately postmenstrual and at the time of ovulation. We used 2D transvaginal ultrasound to predict chronic endometritis, we searched for 1) presence of persistent endometrial focal or diffuse thickening postmenstrual, 2) presence of focal echogenic foci in the triple line endometrium during ovulation. The 3D ultrasonography was done as confirmatory examination. Office hysteroscopy as the main method for diagnosis of endometritis was performed to all patients either after menses if the first sign was detected or at the time of ovulation if the second sign was detected.Results: The combination of persistent endometrial shreds and/or endometrial focal thickening or echogenicity can significantly predict presence of endometritis as the sensitivity and specificity of the combination were 94.90 and 81.37, respectively.Conclusions: Bi-dimensional ultrasonography done to infertile women at 2 phases of the menstrual period can predict the presence of chronic endometritis as a subtle cause of infertility and might be an indication for hysteroscopic evaluation for these patients.

A Pitfall in Prenatal Ultrasonic Detection of Submucous Cleft Palate

Objective: We present a case with prenatal diagnosis of submucous cleft palate (SMCP) which was described using 2- and 3-dimensional (3D) ultrasonography in utero. Case Report: A 25-year-old pregnant woman was referred to our department for fetal ultrasound screening. After the detection of cardiac and spinal malformations of fetal, further detailed examination detected SMCP, which showed a gap within the hard palate on axial transversal view with the soft palate visible on sagittal view. The imaging of a defective hard palate in prenatal 3D ultrasonography is similar to that in postmortem 3D computed tomography reconstruction. Conclusion: A gap within the hard palate and verification of the visibility of the soft palate should be key points in the prenatal diagnosis of SMCP. Three-dimensional ultrasonic imaging is helpful for displaying the shape and extent of the bony defect in SMCP.

Prenatal Diagnosis of FATCO Syndrome (Fibular Aplasia, Tibial Campomelia, and Oligosyndactyly) with 2D/3D Ultrasonography

IntroductionFibular hemimelia is a congenital lower limb anomaly characterized by the partial or complete absence of the fibula. It includes a spectrum ranging from mild fibular hypoplasia to complete fibular aplasia. Although rare in occurrence, it is the most common congenital absence of long bone of the extremities 1.

Ultrasound diagnosis of myelomeningocele: the role of 3D ultrasonography in determining surficial status of the pathological lesion

ObjectivesSpina bifida manifests in various forms, and the clinical imaging findings depend on the level of the vertebral defect. It is difficult to predict the severity of the neurological symptoms and the degree of urgency of early treatment antenatally.Case presentationIn the present case report of fetal myelomeningocele (MMC), three-dimensional (3D) ultrasound showed accurate findings of fetal back surficial skin and tissue defect. The neonatologist and surgeons were able to decide upon appropriate treatment strategies on the basis of these findings.Conclusions3D ultrasound helps provide information to neonatologists and neurosurgeons about the initial treatment and illustrates the physical appearance of the disease for the parents of the unborn child.