Everything about Hysterosalpingography totally explained
Hysterosalpingography (
HSG) is a
radiologic procedure to investigate the shape of the uterine cavity and the shape and patency of the
fallopian tubes. It entails the injection of a radio-opaque material into the
cervical canal and usually
fluoroscopy with image intensification. A normal result shows the filling of the uterine cavity and the bilateral filling of the fallopian tube with the injection material. To demonstrate tubal patency spillage of the material into the
peritoneal cavity needs to be observed.
The procedure involves ionizating
x-rays and should be done in the preovulatory phase of the cycle; it's contraindicated in pregnancy. It is useful to diagnose
uterine malformations,
Asherman's syndrome,
tubal occlusion and used extensively in the work-up of
infertile women. It has been claimed that pregnancy rates are increased in a cycle when an HSG has been performed. Using catheters, an interventional radiologist can open tubes that are proximally occluded.
The test is usually done with radiographic
contrast medium (dye) injected into the
uterine cavity through the
vagina and
cervix. If the
fallopian tubes are open the contrast medium will fill the tubes and spill out into the
abdominal cavity. It can be determined whether the fallopian tubes are open or blocked and whether the blockage is located at the junction of the tube and the uterus (proximal) or whether it's at the end of the fallopian tube (distal).
Complications of the procedure include
infection,
allergic reactions to the materials used,
intravasation of the material, and, if oil-based material is used,
embolisation.
For the first HSH Carey used
collergol in 1914.
Lipiodol was introduced by Sicard and Forestier in 1924 and remained a popular contrast medium for many decades. Later, water-soluble contrast material was generally preferred as it avoided the possible complication of oil embolism.
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