OC058: Septate uterus: correlation of three‐dimensional power Doppler sonography of the septum with histology of septal tissue after hysteroscopic metroplasty
Year: 2008
Type: conference-abstract
Abstract: Several mechanisms have been proposed to explain infertility and early pregnancy loss in case of septate uterus. As possible etiological factors some authors suggest a poor vascularization in connective or fibro-elastic septal tissue, unable to provide adequate blood supply to the developing embryo. In contrary other studies suggest that pregnancy wastage is caused by higher contractility due to the increased muscle content. The aim of our study was to evaluate the histological structures of specimens of uterine septa obtained by hysteroscopic metroplasty and to correlate the findings to 3D transvaginal ultrasound (3D TVS) echostructure and vascularization of the septum. Sixteen patients with recurrent miscarriage or infertility and septate uterus underwent hysteroscopic metroplasty. On 3D TVS coronal view of the uterus, septal length, width, volume, echostructure and vascularization by means of the Vascularisation Index (VI), were evaluated. During hysteroscopic removal of the uterine septum at least two specimens of the septum were obtained for histological evaluation. Histology of the septum showed in 6 cases more connective tissue and few vessels and in 10 cases normal myometrium and vessels with thick muscle wall. 3D TVS of the 10 septa with myometrium content showed VI of the septum (12.6 ± 2.7%) significantly higher compared to the 6 cases with fibrotic septa (VI 4.3 ± 3.2%). Increased uterine bleeding during hysteroscopic resection of the septum was observed in 7 patients, all with histological findings of prevalent muscle content in the septum and VI > 10%. Uterine septa can contain prevalent connective poor vascularized tissue or normal vascularized myometrium. 3D TVS can suspect these different types of septal content. The different histological findings of uterine septal content suggest that probably pathogenesis of infertility in these patients is multifactorial and not caused only by the type of the septal tissue.
DOI: 10.1002/uog.5466
Institutions: University of Rome Tor Vergata, Fatebenefratelli Hospital
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2051294418