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Sonohysterography for screening in recurrent pregnancy loss
M D Keltz1, D L Olive, A H Kim
1Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut, USA.
Fertility and Sterility
|April 1, 1997
Summary
Sonohysterography accurately screens the uterine cavity for recurrent pregnancy loss causes. This imaging technique shows high sensitivity and specificity, proving superior to hysterosalpingography for diagnosing intrauterine abnormalities.
Area of Science:
- Reproductive medicine
- Diagnostic imaging
Background:
- Recurrent pregnancy loss (RPL) affects numerous women.
- Identifying uterine cavity defects is crucial for managing RPL.
Purpose of the Study:
- To assess sonohysterography's effectiveness in screening the uterine cavity for patients experiencing recurrent pregnancy loss.
- To compare sonohysterography with hysterosalpingography and hysteroscopy for diagnosing intrauterine abnormalities.
Main Methods:
- Prospective evaluation of 34 women with a history of at least two consecutive pregnancy losses.
- Sonohysterography performed using saline infusion and concurrent vaginal sonography.
- Comparison of findings with hysterosalpingography and hysteroscopy/laparoscopy.
Main Results:
- Sonohysterography identified intrauterine abnormalities in 50% of cases (17/34).
- Sonohysterography demonstrated 100% sensitivity and specificity, with 100% accuracy in diagnosing defects confirmed by surgery.
- Hysterosalpingography showed lower accuracy (45.5%) and specificity (20.0%) compared to sonohysterography.
Conclusions:
- Sonohysterography is a highly sensitive, specific, and accurate tool for evaluating uterine cavitary defects in recurrent pregnancy loss.
- Sonohysterography offers significant advantages over hysterosalpingography for RPL screening.