P26.08: Screening for congenital uterine anomalies by three‐dimensional transvaginal ultrasound in premenopausal women: the online added information

To establish the feasibility of applying three-dimensional transvaginal ultrasound (3DTVUS) in an unselected population of premenopausal women, in screening for congenital uterine anomalies (CUA). Secondary aims were to estimate the incidence of CUA in this population and to determine the on-line added information of 3DTVUS. The prospective study used 3DTVUS as a screening tool for CUA, after 2D gynecological scanning. Two observers were involved in the study, interpreted on-line the acquired volumes of the uterus, and classified them using the ASRM (American Society for Reproductive Medicine) classification system, with a further division, in major and minor anomalies. The study included 3155 volume datasets for interpretation, from which 3004 (95.21%) were declared as interpretable. We had an incidence of 2.25% major CUA and 6.75% - minor ones. Age range was 16 to 53 and mean age was 31.4. 2902 (91.9%) women were Caucasian. The main indication for imaging was routine medical examination. The most common reason for inadequate assessment of uterine shape was the poor visibility of the endometrium, related to the menstrual cycle day. Associated pathology (like fibroids, adenomyosis, polyps and endometriosis) rarely interfered the proper visualisation of the internal contour. In a subset of 145 cases with CUA with corporeal distortion only, magnetic resonance imaging (MRI) offered no additional information. The 3DTVUS modified the 2D classification in 21 (29.5%) cases of major CUA and excluded 54 minor CUA. In our unselected patient population the 3DTVUS assessment of the shape of the uterus was possible in 95.21% of cases. This study demonstrates the feasibility of incorporating the on-line 3D sonographic evaluation of corpus uterine anatomy in routine gynecology scanning. This simple and low time consuming examination may serve as a screening tool to identify patients in need of increase surveillance in pregnancy or in those undergoing endouterine manoeuvres.