Diagnostic performance of two-dimensional ultrasound, two-dimensional sonohysterography and three-dimensional ultrasound in the diagnosis of septate uterus-a systematic review and meta-analysis
Keywords: 
Ultrasound
Sonohysterography
Septate uterus
Mullerian anomalies
Mullerian duct anomalies
Female genital-tract
Congenital uterine anomalies
Transvaginal sonography
Cavity assessment
Infertile women
Eshre-esge
Accuracy
Classification
Issue Date: 
2023
ISSN: 
2075-4418
Note: 
This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).
Citation: 
Alcázar-Zambrano, J. (Juan Luis); Carriles-Rivero, I. (Isabel María); Cajas, M. B.; et al. "Diagnostic performance of two-dimensional ultrasound, two-dimensional sonohysterography and three-dimensional ultrasound in the diagnosis of septate uterus-a systematic review and meta-analysis". Diagnostics. 13 (4), 2023, 807
Abstract
Background: The septate uterus is the most common congenital uterine anomaly, and hysteroscopy is the gold standard for diagnosing it. The goal of this meta-analysis is to perform a pooled analysis of the diagnostic performance of two-dimensional transvaginal ultrasonography, two-dimensional transvaginal sonohysterography, three-dimensional transvaginal ultrasound, and three-dimensional transvaginal sonohysterography for the diagnosis of the septate uterus. Methods: Studies published between 1990 and 2022 were searched in PubMed, Scopus, and Web of Science. From 897 citations, we selected eighteen studies to include in this meta-analysis. Results: The mean prevalence of uterine septum in this meta-analysis was 27.8%. Pooled sensitivity and specificity were 83% and 99% for two-dimensional transvaginal ultrasonography (ten studies), 94% and 100% for two-dimensional transvaginal sonohysterography (eight studies), and 98% and 100% for three-dimensional transvaginal ultrasound (seven articles), respectively. The diagnostic accuracy of three-dimensional transvaginal sonohysterography was only described in two studies, and we did not calculate the pooled sensitivity and specificity for this method. Conclusion: Three-dimensional transvaginal ultrasound has the best performance capacity for the diagnosis of the septate uterus.

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