Three-dimensional ultrasound in the diagnosis and the classification of congenital uterine anomalies using the ESHRE/ESGE classification: a diagnostic accuracy study

Kougioumtsidou, Anna; Mikos, Themistoklis; Grimbizis, Grigoris; Karavida, A.; Theodoridis, Theodoros; Sotiriadis, Alexandros; Tarlatzis, Basil C.; Athanasiadis, Apostolos

doi:10.1007/s00404-019-05050-x

Cited by 31 publications

(28 citation statements)

References 27 publications

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“…In the diagnosis of female genital tract anomalies, 2D ultrasound has 67.3% sensitivity and 98.1% specificity (12), and 3D has 98.3% sensitivity and 99.4% specificity (12). Because vaginal ultrasound cannot be applied in patients with vaginal aplasia, transperineal 3D ultrasound can depict pelvic structures including the vagina and the cervix (12,13). A patient's anatomic characteristics (body habitus, retroversion of the uterus, previous surgeries) may compromise obtaining the required planes.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Current knowledge about the management of congenital cervical malformations: a literature review

Mikos

Gordts²,

Grimbizis

2020

Fertility and Sterility

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The prevalence of congenital cervical agenesis or dysgenesis ranges from 1/80,000 to 1/100,000, and in about 50% of these cases it coexists with congenital vaginal agenesis. This narrative review summarizes the contemporary knowledge in the field of conservative surgical restoration of the reproductive tract. The management of congenital cervical malformations aims to [1] provide relief from the obstructive symptoms, [2] establish normal sexual function, and [3] preserve the uterus for future fertility. In cases of cervical agenesis and vaginal aplasia, the surgical approach involves the creation of neovagina, the creation of neocervix, and then subsequent restoration of the continuity of the genital tract. In cases where vagina is not congenitally absent, the surgical approach involves either a direct uterovaginal anastomosis or initial creation of neocervix and then subsequent restoration of the continuity of the genital tract. The neocervix can be surgically created with small intestinal submucosa, split-thickness skin graft, full-thickness skin graft, peritoneal flap, or vaginal mucosa lined with a polytetrafluoroethylene graft. Most of the published cases report long-term menstruation and sporadic pregnancies. Conservative surgery of cervical congenital malformations could serve as a first-line treatment. Sexual function and menstruation are established in the majority of patients. Extirpatory surgery may be preserved for surgical failures after initial restoration of the continuity of uterus-cervix-vagina or in cases with more complex anatomy. (Fertil Steril Ò 2020;113:723-32. Ó2020 by American Society for Reproductive Medicine.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Current knowledge about the management of congenital cervical malformations: a literature review

Mikos

Gordts²,

Grimbizis

2020

Fertility and Sterility

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“…In the diagnosis of uterine malformations, the 3D-SIS imaging was identical to HL [62]. Another study performed on 61 cases verified the concordance between three-dimensional ultrasound (3D US) and HL according to type and classification of uterine abnormality, highlighting in the case of the septate uterus (sensitivity of 100% and a specificity of 92.3%) [63]. The diagnosis of Müllerian anomalies suspected by hysterosalpingography/MRI and confirmed by the HL was replaced by using a 3D US, which, according to Berger et al, has become a gold standard [64].…”

Section: How Can Hl Manage Uterine Malformations?mentioning

confidence: 76%

Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology

Varlas

Rhazi

Cloțea

et al. 2021

JCM

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Background: Combined hysteroscopy and laparoscopy is a valuable method for diagnosing and treating infertility and benign uterine pathology. Both procedures are minimally invasive, reliable, and safe, with a low complication rate. Aim: In this review, we expose the efficiency and safety of hysterolaparoscopy in the management of infertility and other benign uterine pathologies. Method: We performed a systematic literature review on several databases: PubMed®/MEDLINE, PMC, Crossref.org, and Web of Science in the last 10 years. Inclusion criteria: Women of reproductive age with primary or secondary infertility and/or benign uterine pathology. Exclusion criteria: pre-puberty, menopause, couple with male infertility. Conclusion: Hysterolaparoscopy is a useful tool to assess infertility and simultaneously diagnose and treat pelvic and uterine lesions.

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“…Of these, 729 were duplicates and 1674 were excluded after reading the title and abstract as they were not related to T‐shaped uterus (Figure 1). We evaluated 132 potentially eligible records in full text, of which 112 were excluded because T‐shaped uterus was related to DES exposure ( n = 64) 5,13–75 ; the article was not related to T‐shaped uterus ( n = 26) 76–101 ; the study included fewer than 10 women with a T‐shaped uterus ( n = 15) 4,102–115 ; no detailed results for T‐shaped uterus were reported ( n = 4) 116–119 ; and the article was a descriptive review ( n = 3) 120–122 . Therefore, 20 studies were eventually included in this systematic review 2,9,123–140 (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Definition, prevalence, clinical relevance and treatment of T‐shaped uterus: systematic review

Neto

Ludwin

Martins³

2021

Ultrasound in Obstet & Gyne

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Objectives To summarize in a systematic review the current evidence regarding definitions, diagnosis, prevalence, etiology, clinical relevance and impact of surgical treatment for T‐shaped uterus not related to diethylstilbestrol (DES) exposure, and to highlight areas on which future research should focus. Methods A search of PubMed, Scopus and EMBASE was performed on 9 April 2020 using the search terms ‘t‐shaped OR t‐shape OR infantile OR (lateral indentation) OR (diethylstilbestrol OR DES) AND (uterus OR uterine OR uteri) AND (anomaly OR anomalies OR malformation OR malformations)’. Additionally, the reference lists of the included studies were searched manually for other relevant publications. All studies presenting data on T‐shaped uterus not associated with DES exposure and including at least 10 women were considered eligible. Studies regarding DES‐related T‐shaped uterus were excluded because DES has not been used since 1971. There were no restrictions on language, date of publication or status of publication. Results Of 2504 records identified by the electronic search, 20 studies were included in the systematic review. The majority of studies were of poor quality. In 11 of 16 studies reporting on the diagnosis of T‐shaped uterus, the diagnostic method used was three‐dimensional ultrasound. There is no consensus on the definition of T‐shaped uterus, but the most cited criteria (4/16 studies) were of the European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy (ESHRE/ESGE; 2013). The prevalence of T‐shaped uterus varied from 0.2% to 10% in the four included studies reporting such data. With respect to etiology (except for DES), T‐shaped uterus was considered a primary condition in three studies and secondary to adhesions in five and adenomyosis in one. T‐shaped uterus was related to worse reproductive outcome based on subfertility (nine studies), miscarriage (seven studies), preterm delivery (two studies), ectopic pregnancy (one study) and repeat implantation failure (seven studies). Of the 12 studies that reported on the effects of surgical treatment of T‐shaped uterus by hysteroscopic metroplasty, some mentioned an improvement in pregnancy rate (rates ranging from 49.6% to 88%; eight studies), live‐birth rate (rates ranging from 35.1% to 76%; seven studies) and term‐delivery rate (four studies) and a reduction in miscarriage (rates ranging from 7% to 49.6%; five studies) and ectopic pregnancy (one study). However, the evidence is of very low quality with serious/critical risk of bias toward overestimating the intervention effect. Some authors reported no complications related to the procedure, while others mentioned persistence of the dysmorphism (rates ranging from 1.4% to 11%; three studies), bleeding (1.3%; one study), infection (2.6%; one study) and adhesions (11.1% and 16.8%; two studies). Conclusions The prevalence, etiology and clinical relevance, with respect to reproductive outcome, of T‐shaped uterus remain unclear and there is no conse...

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Three-dimensional ultrasound in the diagnosis and the classification of congenital uterine anomalies using the ESHRE/ESGE classification: a diagnostic accuracy study

Cited by 31 publications

References 27 publications

Current knowledge about the management of congenital cervical malformations: a literature review

Current knowledge about the management of congenital cervical malformations: a literature review

Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology

Definition, prevalence, clinical relevance and treatment of T‐shaped uterus: systematic review

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