Comparison between 3D-transvaginal ultrasound and hysteroscopy in detecting uterine cavity abnormalities

Background: unsuspected uterine cavity abnormalities, such as endometrial polyps, small submucous myomas, adhesions, and uterine septum may cause different gynecological complaints such as bleeding and negatively impact chances of success in ART by interfering with implantation or causing spontaneous abortion. Therefore, exclusion of intrauterine pathology is an important step before starting ART and treatment of any discovered lesion may improve ART outcome. The uterine cavity can be evaluated by hysterosalpingography [HSG], transvaginal ultrasound [TVS], sonohysterography [SHG], and hysteroscopy. Hysteroscopy is the gold standard for investi-gation of the uterine cavity, particularly when pathology is suspected

Objective: to assess diagnostic accuracy of three dimensional transvaginal ultrasound [3D-TVS] compared with hysteroscopy in detecting uterine cavity abnormalities

Study design: this prospective observational cross-sectional study was conducted during the January 2018 to June 2018. One hundred women with different uterine pathologies were enrolled. In the mid to late follicular phase of each subject's menstrual cycle, three D transvaginal ultrasound and hysteroscopy were performed in each patient. Hysteroscopy is widely considered to be the gold standard method for investigation of the uterine cavity. Uterine cavity characteristics and abnormalities were recorded. Diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios were evaluated

Results: hysteroscopy was successfully performed in all subjects. Hysteroscopy diagnosed pathological findings in 100 of 100 cases [100%]. There were 50 endometrial polyps, 13 submucous myomas, 29 septate uterus, and 8 intrauterine adhesions. Three-dimensional transvaginal ultrasound in comparison with hysteroscopy had 85% diagnostic accuracy, 68.2% sensitivity, 91.5% specificity, 79% positive predictive value, and 86% negative predictive value. The positive and negative likelihood ratios were 8.01 and 0.3, respectively. 3D-TVS successfully detected every case of submucous myoma. For detection of endometrial polyps, 3D-TVS had 80.0% sensitivity, 100.0% specificity, and 90% diagnostic accuracy. For detection of septate uterus, 3D-TVS had 93.10% sensitivity, 100.0% specificity, and 98% diagnostic accuracy

Conclusion: three D-TVS demonstrated 84.1% diagnostic accuracy for detecting uterine cavity abnormalities in infertile women. A significant percentage of patients had evidence of uterine cavity pathology. Hysteroscopy is, therefore, recommended for accurate detection and diagnosis of uterine cavity lesion

cytogenetice and immunologic studies in recurrent fetal losses.

The aim of this study was to evaluate the cytogenetic and immunologic role in human reproduction. The study included 158 women with history of repeated fetal losses, their ages ranged between 18-45 years [mean = 31 years] and the number of previous losses ranged between 2-8 [mean = 4]. The clinical evaluation, pedigree construction, pelvic ultrasound examination was done to all cases. Chromosomal studies were done to 66 couples with history of early fetal losses [during 1st trimester] using GTG-banding technique. A total number of 120 pregnant women with history of fetal losses and 30 normal pregnant women used as controls was subjected to a further immunologic investigation. Anticardiolipin antibodies were measured using ELISA and lupus anticoagulant [LA] by activated partial thromboplastin time [APTT]. The study concluded that both genetic and immunologic factors have been identified as causes of repeated fetal losses. However, chromosomal aberrations play an important role in the etiology of early fetal losses

Comparative study of abortion in two Egyptian hospitals

Abortion is a humanitarian problem which comprises both medical and social aspects. This study aimed to estimate the magnitude of the social impact on abortion through a comparative study of cases of abortion representing two distinctive trial areas [Shoubra -El- Kheima]. The material of this study includes 108 cases admitted to Al-Azhar University Hospital in Bab-El-Sharia and 106 cases admitted to Nasser General Hospital in Shoubra-El-Kheima during the period from first of June till the end of August. The data collected by questionnaire. The results emphasis the effects of age, occupation, education, pregnancy order, pregnancy order, period of gestation, age of menarche, family size and number of abortion. The researchers recommend a more constructive cooperation between medical, social and labor services

leukorrhea long attendants of the gynecology outpatients of Fayoum general hospital

Leucorrhoea among attendants to the gynecology OPD In Fayoum Hospital had been studied and its case morbidity ratio was found to show physical changes in color, odor and consistency and only 4 cases were purulent but in the majority the change was only in quantity. Gynecologically, the commonest lesion associated was cervicitis, followed by vaginitis. The change of vaginal flora might be from the host himself or environmental