Efficacy of Transrectal Three-Dimensional Ultrasound-Guided Hysteroscopic Metroplasty
Bibliographic record
Abstract
Background: Transabdominal ultrasound is not the standard for scanning pelvic structures, and the transvaginal route can result in repeated removals and reinsertions of the hysteroscope, with subsequent uterine refilling. Objective: The goal of this research was to evaluate the efficacy of transrectal 3-D ultrasound for intraoperative guidance during hysteroscopic metroplasty. Design: This pilot, prospective, randomized comparative study (Canadian Task Force classification I) was conducted in the Shatby Maternity University Hospital in Alexandria, Egypt. Materials and Methods: The study involved 60 patients with infertility or recurrent pregnancy-loss problems, who were diagnosed by hysterosalpingogram (HSG) and 3-D vaginal ultrasound to have uterine septa. The patients were randomized into two groups. Group A (30 patients) had hysteroscopic metroplasty with transrectal 3-D ultrasound performed intermittently during the procedure. Group B (30 patients) had hysteroscopic metroplasty without ultrasound guidance. All patients had postoperative HSG 3 months later. Results: A statistically significant longer operative time was found in group A (p=0.001). No statistically significant difference was found between both groups regarding volume of fluid deficit and intraoperative complications. No residual septa were found on HSG 3 months postoperatively in group A, while 4 cases (13.3%) of residual septa were seen in group B, with a significant statistical difference between both groups (p=0.04). Conclusions: Transrectal, 3D, ultrasound-guided hysteroscopic metroplasty seems to be a reliable, safe noninvasive tool that enables complete precise removal of a uterine septum in one session with no residual tissue remaining and no myometrium injury, thus eliminating the risk of uterine rupture in subsequent pregnancies. Moreover, there is no need for intraoperative laparoscopic monitoring or postoperative HSG. (J GYNECOL SURG 30:209)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".