Three-dimensional reconstructed coronal plane in detection and differentiation of congenital uterine malformations

Abstract

Background: Congenital uterine malformations develop during early embryogenesis, and their possible impact on female reproduction often represent a diagnostic and therapeutic challenge. In this study, the authors aimed to evaluate the possibility of detection and differentiation of Müllerian uterine anomalies on the basis of coronal plane obtained by three-dimensional transvaginal ultrasonography. Materials and Methods: The authors investigated 310 non-pregnant women who underwent three-dimensional ultrasound (3-D US) examination followed by the reconstructed three-dimensional images in the coronal plane. The patients were divided into two groups: infertile and unselected women. Results: Müllerian duct anomalies were diagnosed in 25 patients (8%). In the group of infertile patients the number of assessed anomalies was higher (16; 14.4%) as compared to the unselected patients (9; 4.6%). The prevalence of uterine anomalies was increased in the group of infertile patients. In the group of infertile patients, the length of uterine cavity was decreased compared to the unselected women (p = 0.0021). This difference was also visible in the case of nulliparous women from both groups (p = 0.0070). On the other hand, the thickness of fundal myometrium and the distance between the two internal tubal ostia did not vary among patients (p > 0.05). Conclusions: 3-D US represents a feasible and accurate technique for the detection and differentiation of congenital uterine malformations. Three-dimensional reconstructed coronal view could be used for the additional measurement of different uterine dimensions which were shown to differ between infertile patients and the control group, and according to the parity.