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Hum. Reprod. Advance Access originally published online on October 21, 2004
Human Reproduction 2005 20(1):253-257; doi:10.1093/humrep/deh557
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Human Reproduction vol. 20 no. 1 © European Society of Human Reproduction and Embryology 2004; all rights reserved

A comparative study of three-dimensional saline infusion sonohysterography and diagnostic hysteroscopy for the classification of submucous fibroids

R. Salim, C. Lee, A. Davies, B. Jolaoso, E. Ofuasia and D. Jurkovic1

Department of Obstetrics and Gynaecology, King's College Hospital, London, UK

1 To whom correspondence should be addressed at: Early Pregnancy and Gynaecology Assessment Unit, Suite 8, Golden Jubilee Wing, King's College Hospital, London SE5 8RX, UK. Email: davor.jurkovic{at}kcl.ac.uk

BACKGROUND: The purpose of this study was to compare three-dimensional saline infusion sonohysterography (3D SIS) and diagnostic hysteroscopy for the diagnosis and classification of submucous uterine fibroids. METHODS: This was a prospective double-blind study of 49 women who presented with a history of menorrhagia, diagnosed on non-enhanced two-dimensional ultrasonography with submucous fibroids. Fibroids were classified on 3D SIS according to the proportion of fibroid contained within the endometrial cavity, using the European Society of Hysteroscopy Classification of Submucous Fibroids. These results were then compared with the findings at diagnostic hysteroscopy. RESULTS: A total of 61 submucous fibroids was identified in 49 symptomatic women. Diagnostic hysteroscopy confirmed these findings in all cases. There was agreement between the two methods in 11/12 cases of Type 0 fibroids (92%), 34/37 (92%) of Type I fibroids and 9/12 (75%) of Type II fibroids. The overall level of agreement was good with a kappa value of 0.80. CONCLUSIONS: There is a good overall agreement between 3D SIS and diagnostic hysteroscopy in classification of submucous fibroids. Agreement is better in cases where a greater proportion of the fibroid is contained within the uterine cavity.

Key words: hysteroscopy/saline infusion sonohysterography/submucous fibroids/three-dimensional ultrasound


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