The Value of Three-dimensional Ultrasound in Diagnosis of Congenital Uterine Anomalies

Background

T. Arkania, A. Gvenetadze.

Reproductive Clinic of Zurab Sabakhtarashvili, Tbilisi State University, Georgia.

Objective

To investigate potential value of three-dimensional ultrasound for the assessment of normal uterine anatomy and the diagnosis of congenital uterine anomalies.

Methods

Study was performed at Reproductive clinic of Zurab Sabakhtarashvili (Tbilisi, Georgia) between May 2016 – October 2016. We studied all the patients with a history of infertility, recurrent pregnancy loss and suspicious müllerian anomalies. Age of patients ranged between 23-40 years. Patients first underwent two-dimensional transvaginal scaning, in all the suspicious cases three-dimensional ultrasound examination was performed. In cases of unclear picture, repeated scanning was performed in late luteal phase of the spontaneous cycle. All the three-dimensional ultrasound volumes were recorded and stored in machine memory. We used ESHRE/ESGE consensus on classification of female genital tract congenital anomalies (Ludvin et al., 2014).

Results

Final evaluation showed congenital uterine anomalies in 28 cases. 20 of them were patients with infertility (71.4%) and 8 with RPL (28.6%). From 28 cases 22 was partial septated uterus – U2a (78.6%), 3 – T-shaped uterus – U1a (10.7%), 2 hemi uterus - U4a (7.1%) and one patient with two uterus with separated cervixes – U1c (3.6%). Among 8 patients with RPL 7 (87.5%) had partial septated uterus (U2a) and 1 (12.5) T-shaped uterus (U1a). From 22 patients with partial septated uterus (U2a) in 4 cases (18.1%) was performed hysteroscopic metroplasty. In all 4 cases three-dimensional ultrasound diagnosis was confirmed (100%). Pregnancy rate was 1 (25%) from 4 women who underwent metroplasty and 5 (27,7%) from 18 patients with no metroplasty, within 2-5 months follow up period. We don’t have information about pregnancy outcome yet.

Conclusion

It seems, three-dimensional ultrasound has high value for diagnosis of congenital uterine anomalies, which often associate with infertility and RPL problems.