Quels signes échographiques doit-on rechercher (2D/3D) pour affirmer la bonne localisation des implants tubaires ? À propos d’une étude rétrospective de 92 cas

Conclusion L’échographie 3D semble être une méthode de choix pour le contrôle des implants car simple de réalisation et de bonne reproductibilité. Cependant, l’interprétation des images en échographie 3D est parfois difficile. L’étude de la courbure de l’implant semble un élément intéressant à analyser systématiquement lors des contrôles en échographie 3D. Objective The aim of this study is to propose an analysis of the route and the curvature of the Essure® system in 3D ultrasound to determine their correct location so as not to miss a tubal perforation. Methods This is a retrospective single center study during 2 years analyzing 92 3D ultrasound performed by a single sonographer. Implant placement was performed by different operators. One prescribed 3D ultrasound control in case of difficulties with the installation; other indications where systematics. Results The Essure®’s position is right in 79 % of cases. Twenty-eight implants appear incorrectly positioned on ultrasound 3D positioning. Abnormalities found are those described by the classification proposed in the literature. In one case, the curvature of the implant, not taking into account this classification, allowed to evoke a tubal perforation. Among the 28 cases of non-visualized implants in place, 3 cases of wrong position of the implant were confirmed by additional examinations (laparoscopy or HSG). For 14 cases, the ASP or HSG disproved the wrong position of the imp...

Source: Gynecologie Obstetrique and Fertilite - June 15, 2016 Category: OBGYN Source Type: research