The Study Of3DTVU In Measurement Of The Angle At The Central Of The Septum

Objective: Application of3-dimentional transvaginalultrasound（3DTVU) to measure the angle at the central point ofthe septum in women with septate uterus， to explore therelationship between the angle and the residual septum,andreproductive outcome after hysteroscopic septoplasty.Methods: A total of72cases with septate uterus had beendiagnosised by3DTVU,and every patient had been performed bytranscervical resection of septum combined laparoscopy． Toanalyze the feature of septate uterus in the coronal plane of3DTVU,including the fundus,cavity and cervix. The depth of fundalcleft and the angle at the central point of the septum were measured.According to the the initial angle measured by3DTVU,thepatients were divided into small angle group(＜90°) and bigangle group（≥90°）。Postoperatively every patient will be reviewed by3DTVU in3months.Follow-up18months， to explore therelationship between the angle at the central point of septum andreproductive outcome after hysteroscopic septoplasty.Results： All patients were performed by hysteroscopycombined laparoscopy transcervical resection ofseptum(TCRS),without complications,Surgical diagnosis of everypatients accord with preoperative diagnosis of3DTVU100%.22cases were diagnosed as Complete septate uterus,50cases asincomlete septate uterus.After hysteroscopic septoplasty，9caseswith septum residual in big angle group（19cases）， and10caseswith septum residual in small angle group（53cases） have beenobserved by3DTVU， septum residual defined longer than0.5cm.There were statistical relationships between residual septumand the angle at the central of the septum(P=0.016).2casesreceived the second TCRS for residual uterine septum werelonger than1.0cm.Another2cases occurred uterine adhesion inbig angle group.Follow-up18months，the cumulative pregnancyand birth rates were calculated by Kaplan-Meier method.and thecurves compared by the log-rank test.The cumulative18monthprobability of becoming pregnant was33.9%in the patientswith big angle group and55.8%in small angle（χ2=1.098,P=0.295), not significant, and the cumulative18month probability of giving birth to a child was16.4and37.1%respectively (χ2=3.067,P=0.080),not significant different.Conclusions:3DTVU could display a good coronal plane,onwhich the relationship of the cavity and the fundus,the depth of fundal cleft and the angle at the central point of the septum can bedepicted and measured.3DTVU was a practical,reliable andnoninvasive method to diagnose septate uterus. The large angle ismore possible to have residual septum after TCRS.The influence onthe reproductive outcome of the angle at the central of the septumcan not be determined.