Keltz M D, Olive D L, Kim A H, Arici A
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut, USA.
Fertil Steril. 1997 Apr;67(4):670-4. doi: 10.1016/s0015-0282(97)81364-7.
To evaluate the role of sonohysterography for screening of the uterine cavity in patients with recurrent pregnancy loss.
Prospective evaluation of sonohysterography, including comparison with available hysterosalpingography and hysteroscopy.
University referral center.
PATIENT(S): Thirty-four reproductive-aged women with at least two consecutive pregnancy losses.
INTERVENTION(S): Sonohysterography was performed on all patients, using saline instilled through an endocervically placed balloon catheter with concurrent vaginal sonography.
RESULT(S): 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.
CONCLUSION(S): 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.
评估超声子宫造影术在复发性流产患者宫腔筛查中的作用。
超声子宫造影术的前瞻性评估，包括与现有的子宫输卵管造影术和宫腔镜检查进行比较。
大学转诊中心。
34名育龄妇女，至少连续两次流产。
对所有患者进行超声子宫造影术，通过宫颈内置气囊导管注入生理盐水，并同时进行阴道超声检查。
34例超声子宫造影中有17例（50.0%）显示宫腔异常。34例中有18例接受了宫腔镜检查，1例接受了腹腔镜检查。所有检查均证实了超声子宫造影的阳性或阴性结果，敏感性和特异性均为100%。此外，经手术证实的100%（12/12）的缺陷在超声子宫造影中被准确诊断。34例患者中有27例还进行了子宫输卵管造影术，基于宫腔镜检查结果，其敏感性为90.0%，特异性为20.0%，但与手术相比，子宫输卵管造影术仅准确诊断出11例（45.5%）缺陷中的5例。
超声子宫造影术是评估与复发性流产相关的宫腔缺陷的一种高度敏感、特异且准确的筛查工具，与子宫输卵管造影术相比具有多个优势。
