The Dr Betlem Graupera, Head of the Gynaecological Imaging Diagnostic Service at Dexeus Mujer, is part of the group of four experts who have prepared a Guide for the diagnosis of uterine malformations (UM) and lower genital tract anomalies, published by the Spanish Society of Gynaecology and Obstetrics (Sociedad Española de Ginecología y Obstetricia – SEGO).

The guide provides information on the latest work carried out in this area and assesses the diagnostic efficacy of the different examination techniques in terms of sensitivity and predictive value. It also offers prevalence data in the population and indicates that three-dimensional ultrasound (3D ultrasound) is considered the first-line technique in the diagnosis of UM, and must always be accompanied by a careful bimanual gynaecological examination and speculoscopy (for adequate study of the cervix and vagina). Likewise, it offers practical indications for the realization of the capture of the 3D volume, as well as the reconstruction of these volumes to obtain the diagnosis of the malformations.

Hysteroscopic and laparoscopic techniques would be reserved for complex cases or that may benefit from them for their treatment. Magnetic Resonance Imaging (MRI) is increasingly limited in its use in this diagnosis since it rarely provides new information to that provided by 3D ultrasound.

The guide also includes a table that indicates the equivalences between the different types of MU according to the two most used classification systems, that established by the American Fertility Society (AFS) and that of the European Society of Human Reproduction and Embryology and the European Society of Gastrointestinal Endoscopy (ESHRE / ESGE) as well as the ultrasound characteristics of each one, using conventional ultrasound and 3D ultrasound, and offers recommendations to professionals when preparing reports.