***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE By evaluating a series of patients undergoing pelvic sonography  with routine 2-dimensional ( 2D ) as well as 3-dimensional ( 3D ) reconstructed images in the coronal plane , we attempted to characterize the types of additional information that can be obtained . METHODS Ninety r and omly selected patients undergoing transvaginal pelvic sonography were imaged according to a st and ard 2D protocol . A 3D uterine volume was then acquired in the sagittal plane and reconstructed in the coronal plane . The endometrium and surrounding myometrium were evaluated for architecture , masses , the relationship of masses to the endometrial cavity , and the anatomic configuration of the cavity . RESULTS Ninety-one studies were obtained . Additional findings were obtained on the coronal view in 28 studies ( 30.8 % ) . No additional findings were obtained in 63 studies ( 69.2 % ) . Normal endometrial and myometrial findings were obtained by conventional 2D imaging in 42 of 91 patients . Of this group , additional findings were shown in 2 ( 5 % ) patients . Forty-nine of the 91 patients had abnormal findings by 2D imaging . Additional information was obtained in 26 ( 53 % ) of these patients . Added information included uterine anomalies , better definition of the endometrium , more accurate delineation and location of endometrial polyps , location of leiomyomas , visualization of cystic areas within the myometrium , and confirmation of the location of intrauterine devices . CONCLUSIONS The 3D reconstructed view of the endometrium and adjacent myometrium appears to be most helpful after a conventional transvaginal study , showing abnormalities within the endometrium and myometrium but being of little added benefit if the conventional findings are normal PURPOSE The purpose of this study was to assess the value of 3-dimensional sonography in the diagnosis of  congenital müllerian duct anomalies  , which cause  infertility , preterm labor , and first trimester abortion .  METHODS A prospect i ve study was undertaken in which 40 patients with histories of repeated spontaneous abortions or infertility were first examined using conventional 2-dimensional sonography or hysterosalpingography . Three-dimensional transvaginal sonography was then performed . RESULTS Twenty-eight women had müllerian duct abnormalities , and 12 women had normal uterine anatomy . Müllerian duct defects detected in this study were unicornuate uterus ( 3 ) , bicornuate uterus ( 3 ) , complete or partial septate uterus ( 12 ) , arcuate uterus ( 9 ) , and didelphic uterus ( 1 ) . The diagnosis of müllerian duct anomalies in these patients was confirmed by laparoscopic and /or hysteroscopic examinations . Three-dimensional sonography demonstrated all congenital uterine abnormalities with a sensitivity and specificity of 100 % . Separate uterus and bicornuate uterus could be correctly diagnosed using 3-dimensional sonography in 11 ( 92 % ) of 12 cases and 3 ( 100 % ) of 3 cases , respectively . These 2 abnormalities were commonly confused with each other using hysterosalpingography and conventional sonography . CONCLUSIONS Three-dimensional sonography with image reconstruction is less expensive and less invasive than hysterosalpingography for the assessment of uterine anatomy and diagnosis of müllerian duct abnormalities . The ability to visualize both the uterine cavity and the myometrium on a 3-dimensional scan facilitates the diagnosis of uterine anomalies and enables the differentiation of septate from bicornuate uteri for preoperative surgical planning STUDY OBJECTIVE To investigate histologic structures of intrauterine septa resected hysteroscopically . DESIGN Prospect i ve , consecutive study ( Canadian Task Force classification II-2 ) . SETTING University-affiliated hospital . PATIENTS Seventy-six women evaluated for uterine septa and infertility . INTERVENTIONS All patients with diagnosis of uterine septum detected by transvaginal color Doppler ( TVCD ) underwent operative hysteroscopy  in which the most prominent part of the septum was encircled with a hysteroscopic loop electrode and removed . Specimens were sent for histopathologic evaluation . The rest of the septum was divided by monopolar needle electrode until the uterine cavity assumed a globular shape . MEASUREMENTS AND MAIN RESULTS In 63 women ( 82.8 % ) preoperative TVCD revealed septal vascularity typical for radial arteries with mean resistance flow of 0.64 + /- 0.06 , and enlarged sunusoidal and capillary spaces . Histopathologic results revealed fibromuscular tissue with moderately more connective tissue in 55 cases ( 72.3 % ) and myometrial tissue in 21 ( 27.6 % ) . There was no statistically significant difference ( p > 0.05 ) in frequency of septa between patients with primary and secondary infertility . CONCLUSION Intrauterine septa consisted of the same type of tissue as normal myometrium , with many muscular fibers . We suspect that muscular tissue within the uterine septum is a potential cause of irregular contractility and consequently increased abortion rate in these patients . ( J Am Assoc Gynecol Laparosc 8(1):111 - 116 , 2001 OBJECTIVE To determine whether it is possible to identify and diagnose accurately Müllerian anomalies with three-dimensional ( 3-D ) ultrasound ( US ) . DESIGN Controlled blinded clinical study . SETTING Normal human volunteers undergoing infertility evaluation in a university hospital . PATIENTS Forty-two patients who underwent laparoscopy and hysterosalpingography as part of their work up for infertility and were found to have either a normal uterus ( 30 patients ) or a Müllerian abnormality ( 12 patients ) consented to be evaluated with 3-D US by sonographers who were unaware of their infertility history or of their laparoscopy and hysterosalpingography diagnoses . INTERVENTIONS Transvaginal 3-D US evaluation over a 10- to 15-minute duration . MAIN OUTCOME MEASURES Three-dimensional imaging was successful in all cases . RESULTS Sonographers identified a Müllerian anomaly in all cases and came up with the correct classification in 11 of 12 cases . All patients with a normal uterus were identified correctly . CONCLUSIONS In all patients with Müllerian anomalies , 3-D US examination of the endometrial cavity correlated with hysterosalpingography . In 91.6 % of patients , 3-D US correlated with the external uterine configuration observed by laparoscopy . This technique may be used reliably in an office setting to diagnose and classify Müllerian anomalies OBJECTIVE To assess fecundity of infertile women after surgical correction of uterine septum .  DESIGN Prospect i ve controlled trial . SETTING Three academic infertility clinics . PATIENT(S ) Forty-four women affected by septate uterus and otherwise unexplained infertility represented the study group ( group A ) , and 132 women with unexplained infertility were enrolled as control subjects ( group B ) . INTERVENTION(S ) Hysteroscopic metroplasty was performed in group A , and group B was managed expectantly . All women were followed-up for 1 year without any other intervention . MAIN OUTCOME MEASURE(S ) Fecundity rate was calculated as the number of pregnancies per 100 person-months . RESULT ( S ) Pregnancy rate ( 38.6 % vs. 20.4 % ) and live birth rate ( 34.1 % and 18.9 % ) were significantly higher in group A than in group B. The survival analysis showed that the probability of a pregnancy in the twelve-months follow up was significantly higher in patients who had undergone metroplasty than in women with unexplained infertility . The corresponding fecundity ( 10-week pregnancy ) rates were 4.27 and 1.92 person-months in women who had undergone metroplasty and in women with unexplained infertility , respectively . CONCLUSION ( S ) Hysteroscopic resection of the septum improves fecundity of women with septate uterus and otherwise unexplained infertility . Patients with septate uterus and no other cause of sterility have a significantly higher probability of conceiving after removal of the septum than patients affected by idiopathic sterility OBJECTIVE To assess the accuracy of three-dimensional ( 3D ) ultrasound in the diagnosis of congenital uterine anomalies . DESIGN Prospect i ve study . SETTING University hospital . PATIENT(S ) Nulliparae with three or more consecutive miscarriages . INTERVENTION(S ) All women underwent 3D transvaginal ultrasound study of the uterine cavity . MAIN OUTCOME MEASURE(S ) Women with negative ultrasound findings subsequently underwent  office hysteroscopy  , whereas a combined laparoscopic-hysteroscopic assessment was performed in cases of suspected Müllerian anomaly . RESULT ( S ) A specific Müllerian malformation was sonographically diagnosed in 54 women of the 284 included in the study group . All negative ultrasound findings were confirmed at office hysteroscopy . Among the women with abnormal ultrasound findings , the presence of a Müllerian anomaly was endoscopically confirmed in all . Concordance between ultrasound and endoscopy around the type of anomaly was verified in 52 cases , including all those with septate uterus and two out of three with bicornuate uterus . CONCLUSION ( S ) Volume transvaginal ultrasound appears to be extremely accurate for the diagnosis and classification of congenital uterine anomalies and may conveniently become the only m and atory step in the assessment of the uterine cavity in patients with a history of recurrent miscarriage BACKGROUND Congenital uterine anomalies are associated with the highest incidence of reproductive failure and obstetric complications . This study aim ed to summarize the clinical characteristics and prenatal outcome of pregnancy in women with congenital uterine malformations . METHODS This retrospective study evaluated the fertility and obstetric outcome of 116 in patients with uterine malformations with pregnancy in Peking University Third Hospital from June 1998 to June 2009 . A total of 270 r and omly selected pregnant women with a previously confirmed normally shaped uterus as a control group .  Student 's t test and analysis of variance ( ANOVA ) were used to compare means for normally distributed variables . The analysis was carried out using the SPSS . RESULTS Among 21 961 deliveries in Peking University Third Hospital , 116 ( 0.45 % ) were in women with uterine anomalies . A septate uterus was present in 43 ( 37.1 % ) and the uterus didelphys in 28 ( 24.2 % ) of the 116 women identified . Bicornuate uterus , arcuate and unicomate uterus were observed in 12 ( 10.3 % ) , 18 ( 15.5 % ) and 15 ( 12.9 % ) patients , respectively . Patients with uterine anomalies had significantly higher rates of malpresentation ( 38.8 % ) , preterm delivery ( 19.8 % ) , and cesarean section ( 78.5 % ) compared with the group of women with a normal uterus . Patients with uterine anomalies had significantly lower mean birth-weight neonates and a significantly higher incidence of small for gestationalage ( SGA ) neonates ; women with uterus didelphys more frequently required infertility treatment than patients with other uterine anomalies ( P < 0.001 ) . The rate of malpresentation was significantly higher in patients with septated uterus in comparison with patients with uterus unicorns ( P < 0.05 ) . CONCLUSIONS Women with congenital uterinemal formation usually have higher incidence of complications during pregnancy and delivery . A septate uterus appears to be associated with poorer obstetric outcomes OBJECTIVE To evaluate the role of saline infusion sonohysterography ( SIS ) in the investigation of uterine abnormalities and malformations in patients referred for infertility work-up compared with women with abnormal uterine bleeding ( AUB ) . DESIGN Prospect i ve cohort study . SETTING Academically oriented private practice . PATIENT(S ) One thous and nine consecutive women examined by SIS for infertility work-up ( n = 600 , infertility group ) or AUB investigation ( n = 409 , AUB group ) . INTERVENTION(S ) SIS . MAIN OUTCOME MEASURE(S ) Intracavitary abnormalities and uterine anomalies . RESULT ( S ) Among the women in the infertility group , 16.2 % ( n = 97 ) were found to have intracavitary abnormalities , including polyps ( 13.0 % ) , submucous fibroids ( 2.8 % ) , and adhesions ( 0.3 % ) . Significantly , more patients in the AUB group ( 39.6 % , n = 162 ) revealed intracavitary abnormalities , including polyps ( 29.8 % ) , submucous fibroids ( 9.0 % ) , and adhesions ( 0.7 % ) . In contrast , significantly more uterine anomalies were found in the infertility group ( 20 % , n = 120 ) compared with the AUB group ( 9.5 % , n = 39 ) . Arcuate uterus was the most common finding ( 15 % vs 
    Output:
    
Canalization defects reduce fertility and increase rates of miscarriage and preterm delivery .
None of the unification defects reduces fertility but some are associated with miscarriage and preterm delivery .
Arcuate uteri are specifically associated with second-trimester miscarriage .
All uterine anomalies increase the chance of fetal malpresentation at delivery