Examination Methods for Uterine Septum
Jun 01, 2022
Source: Cainiu Health
Dr. Chong Yiwen
Introduction
Diagnostic methods for uterine septum include transvaginal ultrasound, hysteroscopy, and hysterosalpingography (HSG). Transvaginal ultrasound can visualize the shape of the septum and offers a relatively high diagnostic accuracy. Hysteroscopy enables precise classification of the uterine septum type. Hysterosalpingography helps identify cases of 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. It can reveal the shape of the septum—typically Y-shaped—and offers a relatively high diagnostic accuracy for uterine septum, with reported detection rates of approximately 70%. However, suboptimal image resolution may 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 and enables precise classification of uterine septum type. When combined with TVUS, hysteroscopy—along with bladder distension and intrauterine distension fluid—enhances contrast and improves visualization of uterine contours, 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, with an overall accuracy rate of approximately 60%.
