3D Ultrasound Enhances Diagnosis

**arcuate shaped uterus**

Arcuate Shaped Uterus One of the most common abnormalities is a **bicornuate uterus**.

Bicornuate Uterus As shown here, a bicornuate uterus has two uterine horns. Pregnancy within a bicornuate uterus typically occurs within one of the horns and pregnancy outcome is usually as normal as for a fully developed uterus. Surgery is not required for this kind of an abnormality. The uterine abnormality most commonly associated with miscarriages is a **uterine septum**

Septated Uterus This is an abnormality of the hollowing process where a residual midline septum is present. Normal uterine lining does not grow over a septum, so if the embryo implants in the septum, it will not have an adequate blood supply for growth. The traditional way to correct a septum was performing an abdominal surgery called a metroplasty, where the septum was removed, and the uterine walls sewn together. This surgery was not very successful, and nowadays we can remove a septum by hysteroscopy, which provides a much more successful outcome. For a uterine septum, surgery is the correction. Understanding the type of uterine defect one has is critical, because this will determine if surgical intervention is needed to optimize one's chances of a successful pregnancy. A 2D ultrasound can suggest that an abnormality is present, but does not necessarily differentiate among subtle abnormalities. The advantage of 3D ultrasound is that it will better define the specific defect present. Based on this improved image, the best recommendation can be made. 3D ultrasound provides a cost-effective imaging modality, which gives good resolution when differentiating Mullerian anomalies. Dr. Scheerer reports that 3D ultrasound can also be helpful in differentiating the location of abnormal pregnancies. For example, the improved imaging can be helpful in distinguishing a tubal ectopic pregnancy, versus a corneal pregnancy. The technology that makes 3D ultrasound so reliable is evolving rapidly, partly due to the sudden popularity among pregnant women who want the better-defined early fetal images for their baby books. While this is currently in vogue, it is important to understand that there are no long-term studies looking at the effects of 3D ultrasounds in pregnancies. While we don't endorse the use of 3D ultrasound strictly for photo opportunities, we think it is a very valuable tool for finding and evaluating certain uterine abnormalities. This information gives us the opportunity to optimally treat each individual person and maximize the chance for a successful pregnancy.

-- Carl Herbert, MD

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