OC11.02: Quantitative ultrasound measurement of uterine contractility in septate uterus versus normal uteri: a multicentre prospective study

To investigate the differences in uterine contractility in women with septate uterus compared to women with normal uterus throughout the menstrual cycle. This multicentric observational prospective study was carried out in the Catharina Hospital in Eindhoven, Netherlands and in the University of Naples Federico II, Italy from February 2023 and March 2024. The study has included patients with diagnosis of septate uterus. Patients enrolled in the study underwent 2D-3D transvaginal and as a final analysis, a 2D 4-minute video was recorded in a median longitudinal section of the uterus. The characteristics of uterine peristalsis have been expressed in terms of frequency, amplitude, velocity, direction, and coordination. The results were compared with the characteristics of the contractile function of the normal uterus already analysed in our previous study. Analysing the characteristics of myometrial contractility in 29 patients with septate uterus and comparing to 95 women with normal uterus, regardless of the phase of the cycle, there is altered in the myometrial contraction in patients affected by a septate uterus with lower values in Contraction Frequency (CF), Contraction Velocity (CV), Contraction Amplitude (CA) and Contraction Coordination (CC), compared to healthy uterus. On the other hand in Luteal phase, however, contractions are relatively quiescent in order to facilitate embryo implantation, in patients with septate uterus were recorded higher value in all parameters and also the CC was worse than healthy control. The presence of septate uterus, causes alterations in myometrial peristalsis. These data may explain the poor reproductive outcomes observed in the population of women with uterine malformation and opens the door to hysteroscopy metroplasty as treatment to resume normal uterine contractility.