Comparative Study between Hysteroscopy and Three Dimension Ultrasound in Diagnosis of Recurrent Abortion

Abstract Background: Congenital uterine anomalies is a common cause of infertility, preterm labor, first trimester abortion. Its estimated percentage varies between 0.1%-3% in the general population and between 3% to 38% in patients with recurrent spontaneous pregnancy loss or with infertility. The use of 3- D ultrasound with image reconstruction in the diagnosis of congenital uterine anomalies has already been described. Aim of Study: To evaluate and compare the diagnostic validity of 3D ultrasound and hysteroscope in the detection of uterine cavity pathologies in recurrent abortion cases. Patients and Methods: This study was a prospective cohort study, was carried out on 200 patients at Al-Azhar University Hospitals, Al Hussein and Al Syed Galal, between February 2019 and January 2022. Results: Using 3D Ultrasound, can discriminate between normal and abnormal biopsy with AUC of 0.793, level of sensitivity 58.6%, specificity 100.0%, PPV 100.0%, NPV 85.5% and accuracy 88%. Using hysteroscopy, it can discrim-inate between normal and abnormal biopsy with AUC of 0.793, level of sensitivity 75.9%, specificity 100.0%, PPV 100.0%, NPV 91.0% and accuracy 93%. Conclusion: Three dimensional transvaginal ultrasound is relatively inexpensive, is not time-consuming, and can be performed in settings. 3D sonography has a high level of accuracy for most uterine anomalies. Thus, routine use of three dimensional transvaginal ultrasound is a sensitive method to evaluate the endometrial cavity lesions or abnormalities, before resorting to invasive procedure.