Predictive value of sonohysterography in the assessment of uterine cavity in patients with uterine defects: a comparative study

Document Type : Original Article

Author

Department of Obstetrics and Gynecology and Minia Infertility Research Unit, Minia University, Egypt.

Abstract

Objective: To compare between hysterosalpingorame, transvaginal Ultrasound, sonohysterography and hysteroscopy for assessment of uterine factor in sub fertile women.
Patients and methods: in a prospective comparative study a hundred of age-matched women with a history of sub fertility (primary or secondary) were recruited. For all women
hysterosalpingorame, transvaginal ultrasound, sonohysterograghy and hysteroscopy were
done.
Results: Of the study group hysteroscopy diagnosed 70% as normal findings and 30% had
uterine abnormalities that include endometrial polyps (9%), uterine anomaly (11%) and
submucous myoma (10%) . while sonohysterograghy revealed 27 uterine abnormalities
with an overall sensitivity, specificity and negative predictive value of 90%, 100%, and
95.8% respectively. Hysterosalpingography diagnosed 21 uterine abnormalities with an
overall sensitivity, specificity and negative predictive value of 70%, 100% & 88.6% respectively. While transvaginal ultrasound examination revealed 89 cases of normal findings,
and diagnosed 11 uterine abnormalities with an overall sensitivity, specificity and negative
predictive value of 36.6%,100%,95.8% respectively.
Conclusion: Sonohysterograghy is an easier, less expensive, safer and better tolerated alternative to diagnostic hysteroscopy for patients with uterine filling defects noted on HSG. It
is highly sensitive and specific as high as the hysteroscopy. It can be used as a preliminary
test for screening the patients who are candidate for operative hysteroscopy as normal
sonohysterographic examination will not need further evaluation by office hysteroscopy.

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