Sonohysterography for screening in recurrent pregnancy loss.
OBJECTIVE
To evaluate the role of sonohysterography for screening of the uterine cavity in patients with recurrent pregnancy loss.


METHODS
Prospective evaluation of sonohysterography, including comparison with available hysterosalpingography and hysteroscopy.


METHODS
University referral center.


METHODS
Thirty-four reproductive-aged women with at least two consecutive pregnancy losses.


METHODS
Sonohysterography was performed on all patients, using saline instilled through an endocervically placed balloon catheter with concurrent vaginal sonography.


RESULTS
Seventeen of 34 sonohysterograms (50.0%) demonstrated intrauterine abnormalities. Eighteen of 34 cases have undergone hysteroscopy or, in 1 case, laparoscopy. All confirmed the positive or negative sonohysterographic finding, resulting in a sensitivity and specificity of 100%. Additionally, 100% (12/12) of the defects were diagnosed accurately at sonohysterography when confirmed by surgery. Twenty-seven of 34 patients also had a hysterosalpingogram that demonstrated a 90.0% sensitivity and 20.0% specificity based on hysteroscopic findings, yet only 5 of 11 (45.5%) defects were diagnosed accurately at hysterosalpingography when compared with surgery.


CONCLUSIONS
Sonohysterography is a highly sensitive, specific, and accurate screening tool for the evaluation of uterine cavitary defects associated with recurrent pregnancy loss and offers several advantages over hysterosalpingography.
Keltz
M D
MD
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut, USA.
Olive
D L
DL
Kim
A H
AH
Arici
A
A
D000026:Abortion, Habitual / Q000175:diagnosis / Q000000981:diagnostic imaging*; D000328:Adult; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods; D015907:Hysteroscopy / Q000379:methods; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology