P28.05: The prevalence of uterine malformations diagnosed by 3D transvaginal ultrasound in women undergoing surgery for endometriosis

To determine the prevalence of congenital uterine malformations as diagnosed by 3D transvaginal ultrasound in women undergoing surgery for endometriosis. Women referred for pre-operative evaluation at a large tertiary referral endometriosis center underwent a transvaginal ultrasound scan with 3D capabilities, using a 5–9 MHz transvaginal probe. Uterine malformations were classified using the new ESHRE-ESGE consensus. A diagnosis of endometriosis which required surgery was made based on clinical criteria and findings at the time of the ultrasound scan, and women underwent laparoscopic surgery. Intra-operative hysteroscopy was performed for suspected uterine malformations, and external uterine contour was confirmed during laparoscopy. During the study period 94 women underwent surgery, with a mean age of 34 (20-47), median parity 0 (0-6), mean BMI 23.6 (16.9-40.23); 52 (55.5%) were nulliparous, 10 (12.8%) after Caesarean sections. Symptoms and complaints included dysmenorrhea (92.5%), dyspareunia (64.1%), urinary complaints (28.6%), gastrointestinal complaints (53.8%) and infertility (37.2%). Twenty five (26.6%) had undergone IVF treatments with 17 undergoing 3 cycles or more (range 1-16). There were available volumes for 93 women, eighteen had a diagnosis of a uterine malformation (19%): 6 arcuate (33.3%, U1c), 9 septate (50%, U2a partial), 1 bicornuate (5.2%, U3b complete), 1 T-shaped uterus (5.2%, U1a), and 1 undetermined shape (5.2%, U6). The external uterine contour was confirmed at laparoscopy in all but one patient, and endometriosis was confirmed in all. Uterine malformations are common in women undergoing laparoscopic surgery for endometriosis with septate uteri being the most prevalent followed by arcuate uteri. Knowledge of uterine structure is imperative for reproductive outcome evaluation and for determination of perinatal management.