Examination Methods for Uterine Septum
Apr 29, 2022
Source: Cainiu Health
Dr. Chong Yiwen
Introduction
Diagnostic methods for uterine septum include transvaginal ultrasound, hysteroscopy, and hysterosalpingography (HSG).
① Transvaginal ultrasound can visualize the shape of the septum and offers a high diagnostic accuracy.
② Hysteroscopy enables precise classification of the type of uterine septum.
③ Hysterosalpingography reveals the presence of a complete uterine septum.
Uterine septum is one of the major causes of recurrent pregnancy loss in women. Diagnostic modalities include transvaginal ultrasound (TVUS), hysteroscopy, and hysterosalpingography (HSG).
① Transvaginal Ultrasound (TVUS)
TVUS is a simple and widely used method for detecting uterine septum and can reveal the shape of the septum—typically Y-shaped. Its diagnostic accuracy for uterine septum is relatively high, with a detection rate of approximately 70%. However, suboptimal image resolution may easily lead to misdiagnosis, particularly as TVUS cannot reliably distinguish between complete and incomplete uterine septa.
② Hysteroscopy
Hysteroscopy allows direct visualization of the intrauterine cavity, enabling precise classification of uterine septum type. When combined with TVUS, bladder filling and intrauterine distension fluid create optimal acoustic contrast, thereby clearly delineating the uterine contour, width, septal length, and fundal morphology.
③ Hysterosalpingography (HSG)
HSG can identify a completely septate uterus but cannot reliably differentiate it from bicornuate or didelphic uterus. Despite this limitation, HSG maintains relatively high diagnostic accuracy for uterine septum, typically around 60%.
