When uterus sonography is needed in preconception consult?

Preconception consulting following goals for improving mothers’ health and prevent or minimize recurrent adverse out comes. The center for disease control and prevention defined preconception care as a set of intervention that in to identify and modify biomedical, behavioral, and social risks to a woman's health or pregnancy outcome through prevention and management. Preconception evaluation and consulting causes and opportunity to inform women about fertility and pregnancy outcome, for diagnosis of some risks of pregnancy for the mother and fetus, educated them about these risks, and institute appropriate intervention, when possible, before conception.[1]

After management of serious dangerous conditions to one pregnant woman, we have challenge with this question, when sonography is necessary in preconception consult?

A 21-year-old woman, who was 20 weeks pregnant referred to Shahid Beheshti hospital in severe hemorrhagic shock state. Without peripheral pulse rate and Carotid pulse rate: 140/min systolic blood pressure: 45 mmHg. She was so paled and confused. There was no sign and symptom of accident and trauma, but her abdomen was severely tender and broad like in examination. Also, we did not found vaginal bleeding or leak. The emergency laparatomy was done and we encounter to ruptured blind horn pregnancy. The fetus (be seems 20 weeks) was floating in abdominal cavity between intestinal loop, with approximately 4 liter blood and clot, we removed uterian horn. Bimanual vaginal examination have very important role in preconception consult, if a pelvic mass is present, pelvic ultrasonography should be performed for differential diagnosis. Uterus anomalies and new laparoscopy management was reported.[23] Uterine anomalies can be associated with recurrent pregnancy wastage, preterm birth, ectopic pregnancy, intrauterine growth restriction, congenital anomaly and prenatal death. In some cases, interventions to reduce or eliminate the risk of recurrence are available.[4]