Thellier E, Levaillant J-M, Pourcelot A-G, Houllier M, Fernandez H, Capmas P
Service de gynécologie obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France.
Service de gynécologie obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France; Faculty of medicine, univeristé Paris-Sud, 94276 Le-Kremlin-Bicêtre, France; Inserm, Centre of research in Epidemiology and population health (CESP), U1018, 94276 Le-Kremlin-Bicêtre, France.
J Gynecol Obstet Hum Reprod. 2018 May;47(5):183-186. doi: 10.1016/j.jogoh.2018.02.002. Epub 2018 Feb 21.
To assess the efficacy of office hysteroscopy and 3D ultrasound for the diagnostic of uterine anomalies after late foetal loss.
This retrospective observational study took place in the gynaecologic unit of a teaching hospital from 2009 to 2014. Women with late foetal loss (<22 weeks of gestation) had an office hysteroscopy and 3D ultrasound within three months after delivery. The results of the ultrasound and hysteroscopy were recorded and compared.
Eighty women were included with a mean age of 29.8 years (28.2-31.4). Forty-seven women had both hysteroscopy and 3D ultrasound, and a uterine cavity's anomaly (bicornuate uterus, T-Shape uterus and septate uterus) was found in ten women (21%) at 3D sonography and in 13 women (28%) at office hysteroscopy. Concordance between the two exams was very good with a kappa at 0.83. In three cases, a uterine cavity's anomaly was found at hysteroscopy whereas sonography was normal. Anomalies at ultrasound (uterine cavity's anomaly, myometrium anomaly or ovarian anomaly) were found in 27.6% of cases.
Both 3D ultrasound and office hysteroscopy are useful for assessment of the uterine cavity after late foetal loss. The application of these two exams is important, as hysteroscopy is generally used for assessment of the uterine cavity and endometrium, while 3D ultrasound is generally used to identify the precise type of uterine malformation and for the examination of the myometrium and annexes.
评估门诊宫腔镜检查和三维超声对诊断晚期胎儿丢失后子宫异常的疗效。
这项回顾性观察研究于2009年至2014年在一家教学医院的妇科进行。晚期胎儿丢失（妊娠<22周）的女性在分娩后三个月内接受门诊宫腔镜检查和三维超声检查。记录并比较超声和宫腔镜检查的结果。
纳入80名女性，平均年龄29.8岁（28.2 - 31.4岁）。47名女性同时接受了宫腔镜检查和三维超声检查，三维超声检查发现10名女性（21%）存在子宫腔异常（双角子宫、T形子宫和纵隔子宫），门诊宫腔镜检查发现13名女性（28%）存在子宫腔异常。两项检查之间的一致性非常好，kappa值为0.83。在3例病例中，宫腔镜检查发现子宫腔异常，而超声检查正常。超声检查发现异常（子宫腔异常、肌层异常或卵巢异常）的病例占27.6%。
三维超声和门诊宫腔镜检查均有助于评估晚期胎儿丢失后的子宫腔情况。这两项检查的应用都很重要，因为宫腔镜检查通常用于评估子宫腔和子宫内膜，而三维超声通常用于确定子宫畸形的精确类型以及检查肌层和附件。
