Comparative study between hysterosonography, hysterography and hysteroscopy for evaluating the uterine cavity in recurrent aborters

Objective: To evaluate and compare the diagnostic value of hysterosonography, and hysterography using hysteroscopy as the gold standard, in evaluating uterine cavity abnormalities in recurrent aborters. Design: Prospective study. Setting: Department of Obstetrics and Gynecology, Kasr El- Aini Hospital, Cairo University. Patients: 40 patients with a history of recurrent first trimester abortion. Intervention: Hysterosonography, followed by hysterography and hysteroscopy were done for all cases Results: 19 out of 40 cases studied showed intracavitary lesions by both hysterosonography and hysterography, including 6 cases (15%) septal defect, 11 cases (27.5%) with uterine adhesions and 2 cases (15%) with submucous myoma. Two cases of mild intrauterine adhesions were overlooked by both hysterography and hysterosonography and diagnosed only by hysteroscopy. Using hysteroscopy as the gold standard both hysterosonography and hysterography have demonstrated 100% specificity and 90.5% and 95% sensitivity respectively. Conclusion: Hysterosonography provides a sensitive and specific screening tool for evaluating the uterine cavity and it could be an accurate alternative to HSG in screening for uterine abnormalities.