Comparison on diagnosing septate uterus with different diagnostic criteria based on 3D ultrasound
10.13929/j.issn.1672-8475.2025.03.006
- VernacularTitle:基于三维超声以不同标准诊断纵隔子宫
- Author:
Fangcai WU
1
;
Rong HU
1
Author Information
1. 新疆医科大学第一附属医院妇产超声诊断科,新疆超声医学重点实验室,新疆 乌鲁木齐 830054
- Publication Type:Journal Article
- Keywords:
adnexal diseases;
diagnosis;
ultrasonography
- From:
Chinese Journal of Interventional Imaging and Therapy
2025;22(3):178-182
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the value of diagnosing septate uterus based on 3D ultrasound using American Society for Reproductive Medicine(ASRM)-2021,European Society of Human Reproduction and Embryology and European Society of Gynecological Endoscopy(ESHRE/ESGE)-2016,Congenital Uterine Malformation by Experts(CUME)-2018 criteria.Methods A total of 164 women of childbearing age with suspected septate uterus due to obvious indentation of endometrium of fundal(indentation depth≥0.5 cm)and no obvious or mild indentation of serous membrane of fundal muscle(indentation depth＜1.0 cm)revealed by 3D ultrasound were retrospectively collected.Among them,114 cases had previous adverse pregnancy events,including infertility,abortion and ectopic pregnancy,etc.Then 3D ultrasonic manifestations of uterus were observed,the depth(septate length)and angle of endometrial depression and the depth of uterine fundus serosa depression were measured.Septate uterus was diagnosed according to ASRM-2021,ESHRE/ESGE-2016 and CUME-2018 criteria,respectively,and the diagnostic results were compared.For patients with and without previous adverse pregnancy,the diagnostic results of septate uterus using 3 kinds of criteria were compared,and the correlations of septate length and the angle of endometrial depression of septate uterus diagnosed using 3 kinds of criteria and adverse pregnancy events were analyzed.Results Among 164 cases,the diagnosis rate of septate uterus according to ASRM-2021 criteria was 43.90%(72/164),the remaining 28.05%(46/164)were non-septate uterus and 28.05%(46/164)were not clearly diagnosed.According to ESHRE/ESGE-2016 criteria,the diagnosis rate of septate uterus was 96.95%(159/164),and the other 3.05%(5/164)was non-septate uterus.The diagnosis rate of septate uterus based on CUME-2018 criteria was 73.78%(121/164),and 26.22%(43/164)was non-septate uterus.There were significant differences of diagnosing results of septate uterus based on the above three criteria(χ2=32.818-81.387,all P＜0.001).For patients with previous adverse pregnancy events,the diagnosis rate of septate uterus based on ASRM-2021 and CUME-2018 criteria were both higher than that for patients without adverse pregnancy events(both P＜0.05).No significant difference was found between patients with or without adverse pregnancy events based on ESHRE/ESGE-2016 criteria(P=0.981).Among 72,159 and 121 cases of septate uterus diagnosed according to ASRM-2021,ESHRE/ESGE-2016 and CUME-2018 criteria,respectively,57,110 and 91 cases had adverse pregnancy events,respectively.The septate length of septate uterus diagnosed using ESHRE/ESGE-2016 and CUME-2018 criteria were both positively correlated with adverse pregnancy events,and the angle of endometrial depression of septate uterus diagnosed using the above 3 kinds of criteria was negatively correlated with adverse pregnancy events(all P＜0.05).Conclusion Compared with ASRM-2021 and ESHRE/ESGE-2016 criteria,the clinical value of diagnosing septate uterus using CUME-2018 was higher.For patients with previous adverse pregnancy events,the diagnostic value of both ASRM-2021 and CMEC-2018 criteria were relatively high.
