Imaging recommendation · Abdomen · Pelvis

Recurrent pregnancy loss (≥ 2 consecutive), imaging work-up

Q: What's the alternative imaging for recurrent pregnancy loss (≥ 2 consecutive), imaging work-up when hysteroscopy if cavity abnormality?

Diagnostic + operative hysteroscopy (no contrast).

Recommended: Transvaginal US + Saline Infusion Sonohysterography + MRI Pelvis (Mullerian anomaly) is the preferred imaging study for recurrent pregnancy loss (≥ 2 consecutive), imaging work-up. Imaging targets: uterine anomaly (septate especially), fibroids, polyps, adhesions, cervical incompetence.

Recommended study

Transvaginal US + Saline Infusion Sonohysterography + MRI Pelvis (Mullerian anomaly)

MRI No contrast Preferred Abdomen · Pelvis Outpatient Reviewed 2026-05

Imaging targets: uterine anomaly (septate especially), fibroids, polyps, adhesions, cervical incompetence.

If the default doesn't apply

Hysteroscopy if cavity abnormality

Diagnostic + operative hysteroscopy No contrast

Watch-outs

Septate uterus is correctable

Hysteroscopic septoplasty improves live birth rates; distinguish from bicornuate (external fundal contour).

Pearls

Septate uterus is the most common congenital uterine cause of RPL.
Fundal indentation > 10 mm with normal fundal contour = septate; deep external cleft = bicornuate.
Other contributors: antiphospholipid syndrome, thrombophilia, endocrine — imaging is one piece of broader work-up.