Comparison of transvaginal 3D sonohysterography with outpatient hysteroscopy in the evaluation of abnormal uterine bleeding.

OBJECTIVE: To compare transvaginal three-dimensional sonohysterography (3D SHSG) and outpatient hysteroscopy with regards to diagnostic accuracy, procedure time, and patient discomfort with a prospective randomized controlled cohort study in a teaching hospital in London. The study included a population group of 49 women with abnormal uterine bleeding from varied ethnic backgrounds, of which 44 completed the study. Subjects with pregnancies, pelvic infections, large uteruses, suspicious or diagnosed pelvic malignancies, and who did not meet the criteria for day surgery, were excluded. MATERIALS AND METHODS: Patients were randomized into two groups: group 1 had hysteroscopy followed by SHSG while group 2 had SHSG followed by hysteroscopy. Diagnostic accuracy, procedure time, and patient discomfort of SHSG in comparison to hysteroscopy were studied. RESULTS: A total of 44 patients completed the study. The average age of the study population was 44.8 years and the mean parity was 1.8. Nulliparas represented 34.03% of the study population and the average duration of symptoms was 14.8 months. CONCLUSION: In the investigation of women with abnormal bleeding in an outpatient setting, both hysteroscopy and SHSG are comparable in the diagnosis of intracavity lesions, pain rating, and procedure time. However patient acceptability of SHSG was significantly more when compared to outpatient hysteroscopy.

Uncorrected tetralogy of Fallot and pregnancy: a case report.

We report a case of pregnancy in a 34-year-old woman with uncorrected tetralogy of Fallot (TOF). There are more risks in patients without surgical correction. In our case, haemoglobin and haematocrit were higher, oxygen saturation was lower, and right ventricular enlargement was observed. Pregnancy was resolved successfully by caesarean section. Improvement of fetomaternal outcome may be related to corrective procedures before conception to achieve better functional heart capacity. Delicate multidisciplinary medical management is essential for these limited cases to achieve optimal prognosis.