Chapter 17 - Congenital uterine malformations

Summary

Hysterosalpingography (HSG) is the first diagnostic test used for patients with suspected mllerian anomalies. HSG can detect a two-chambered uterus and allow assessment of the size and extent of a septum. Two-dimensional (2D) ultrasonography was previously done by the transabdominal route, but transvaginal ultrasonography (TVS) is superior to the transabdominal route and is now the standard imaging technique for the uterus. The main advantage of three-dimensional (3D) ultrasonography over 2D is the ability to image the three orthogonal planes of the uterus, of which the coronal view is the most important. Sonohysterography is an ultrasound-aided technique that entails injection of normal saline into the uterine cavity. Many magnetic resonance imaging (MRI) studies have shown a very high sensitivity of 100%, and more recently values of 95% have been reported in cases of mllerian anomalies. Uterine mllerian anomalies have a high frequency of adverse obstetric implications.