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Diagnostic accuracy of sonohysterography, hysterosalpingography and diagnostic hysteroscopy in diagnosis of arcuate, septate and bicornuate uterus
Author(s) -
Ludwin Artur,
Ludwin Inga,
Banas Tomasz,
Knafel Anna,
Miedzyblocki Margaret,
Basta Antoni
Publication year - 2011
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2010.01304.x
Subject(s) - medicine , septate , bicornuate uterus , hysterosalpingography , hysteroscopy , diagnostic accuracy , receiver operating characteristic , infertility , gynecology , radiology , uterus , pregnancy , paleontology , genetics , biology
Aim: To evaluate the diagnostic accuracy of sonohysterography (SHG), hysterosalpingography (HSG) and diagnostic hysteroscopy (DH) in uterine anomaly detection and to assess the role of these various modalities in the differential diagnosis of arcuate, septate and bicornuate uteri. Methods: Eighty‐three women, with a history of recurrent spontaneous abortions or infertility and initial diagnosis of uterine anomaly were included in the study. Diagnostic work‐up comprised of SHG, HSG and DH. To assess the accuracy of these methods all the patients underwent hysterolaparoscopy to establish the final diagnosis. The correlation between the results of each method was evaluated and diagnostic accuracy of each method was assessed in the whole group of women as well as in subgroups of arcuate, septate and bicornuate uteri using receiver operator curve (ROC) method by estimating the area under the curve (AUC). Results: In the overall diagnosis of uterine anomalies, SHG with accuracy of 95.2% and correlation index of 0.873 ( P < 0.001) proved to be a significantly better tool compared to DH (SHG AUC = 0.924 versus DH AUC = 0.761 P = 0.008), while no significant differences were observed between SHG versus HSG and DH versus HSG. SHG showed significantly higher accuracy (100.0%) compared to DH (80.7%) and HSG (80.7%) in differentiation of a septate (SHG AUC = 1.000 versus DH AUC = 0.816 P < 0.001 and SHG AUC = 1.000 versus HSG ACC = 0.818; P < 0.001) and bicornuate uterus (SGH AUC = 1.000 versus DH ACC = 0.707; P < 0.001 and SHG ACC = 1.000 versus HSG AUC = 0.790; P = 0.002). Conclusion: SHG is a noninvasive, cost‐effective method available in an outpatient setting that is highly accurate in identifying uterine anomalies, in particular septate and bicornuate uterus.