Apport de l’hystérosonographie pour le diagnostic des isthmocèles

Conclusion L’hystérosonographie permet d’augmenter la sensibilité de l’échographie 3D endovaginale pour le diagnostic des isthmocèles. Elle augmente aussi la pertinence des mesures (limites plus nettes) et donc l’évaluation de la sévérité des déhiscences. Objectives To determine the interest of saline contrast sonohysterography in the evaluation of number, size and shape of cesarean scar defects in comparison with 3D-transvaginal ultrasound examination. Methods Patients who had surgical reparation of cesarean scar defect by operative hysteroscopy were included in this retrospective study. Before surgery, they all had 3D-transvaginal ultrasound examination and saline contrast sonohysterography to establish the diagnosis. Then those two exams were compared to determine which one is better for cesarean scar defect evaluation, in terms of diagnosis and severity. Results Fourteen patients were enrolled, they underwent transvaginal ultrasound and saline contrast sonohysterography before the surgery. 3D-transvaginal ultrasound examination made the diagnosis in 50% of patients with cesarean scar defect, whereas saline contrast sonohysterography enabled to detect 86% of defects, in comparison with hysteroscopy (100%). In 29% of patients, the size and depth of the cesarean scar defect was more important with saline contrast sonohysterography and hysteroscopy than expected by 3D-transvaginal ultrasound examination. After surgical repair, symptoms improvement was f...
Source: Gynecologie Obstetrique and Fertilite - Category: OBGYN Source Type: research