What is a Hysterosalpingogram?

Hysterosalpingography (HSG) has been used since the 1920s. It is a commonly used inspection method in modern gynecological examinations. It can usually detect the cause and location of fallopian tube disease. Many infertile women have I hope to find out the cause through this inspection method.

Hysterosalpingogram

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Hysterosalpingogram is a commonly used inspection method in modern gynecological examinations. It can usually detect the cause and location of fallopian tube diseases. Many infertile women hope to find out the cause by this inspection method.

Fallopian tube angiography is the injection of contrast agent into the uterine cavity and fallopian tube through a catheter, X-rays are used for fluoroscopy and imaging, and then the fallopian tube patency, obstructed part and morphology of the uterine cavity are analyzed according to the contrast agent's development in the fallopian tube and pelvis . This is an effective inspection method.

1.The infertility was not abnormal after the husband's semen examination. The patient's BBT was biphasic and the luteal function was good for 3 consecutive times.

1. Acute and subacute internal and external genital inflammation.

2. Severe systemic diseases.

3. Pregnancy, menstruation, within 6 weeks after hysterectomy.

4. Iodine allergy.

(1) Venous reflux: It may be due to the damage of the endometrium to the device, inflammation of the endometrium, excessive injection pressure, and excessive contrast dose. There are reports in the literature that if oily embolism and allergic reactions occur in patients, the patient may cough, ache, palpitations, irritability, shock and coma after angiography, which can cause choking. Therefore, anti-allergic and rescue shock preparations should be made before surgery.

(2) Infection: The original inflammation caused the onset, or the iatrogenic infection was caused by inadequate aseptic operation, which caused hysteritis, appendicitis, pelvic inflammatory disease, and peritonitis. Attention should be paid to the prevention and treatment of antibiotics and appropriate use of antibiotics.

In order to prevent the infection caused by the residual dirt in the instrument, the sterilization before operation must be free of microbial contamination; after the operation, the catheter and syringe should be washed in the cavity with ether, or soaked in sodium bicarbonate solution to prevent iodine oil from staying in the tube , Cause adverse irritation or infection in the next application. It is best to use disposable devices to prevent cross infection.

(3) If the patient has severe pain after the operation, he should take a rest and observe in the radiology department. If necessary, he should stay in the observation room or be hospitalized to prevent accidents.

(1)

1. The imaging time is selected from 3 days after the menstrual period to the ovulation period, that is, the 7th in the menstrual cycle.

1. The pelvic bath and sexual life are prohibited for 2 weeks after the angiography, and antibiotics can be given to prevent infection as appropriate.

2. Sometimes the phenomenon of tubal obstruction caused by tubal spasm is repeated, if necessary.

3. There is a small amount of vaginal bleeding within one week after the angiography examination. It is normal if there is no other discomfort.

4. It is best to prevent contraception for three months after angiography to reduce the possible effects of x-ray exposure. However, clinical observation found that women who became pregnant that month after angiography did not increase the risk of fetal abnormalities.

1. During the radiography, the patient lies on the X-ray machine operation platform and takes the bladder lithotomy position. Routinely disinfect the vulva and vagina, lay a sterile towel, and check the position and size of the uterus again.

2. Observe the contrast agent flowing through the uterine cavity and fallopian tubes under X-ray perspective and take pictures. Slowly inject lipiodol under fluoroscopy. The injection volume is 3 ~ 5ml for the first time. Observe the situation of entering the uterus and flowing through the fallopian tube. Continue to push in 3 ~ 5ml of lipiodol and take a picture after 5 ~ 10 minutes.

3. Dilate the vagina with a speculum, expose the cervix, disinfect the cervix and fornix with iodophor, fix the front lip of the cervix with cervical forceps, and explore the uterine cavity. Fill the cervical catheter with lipiodol and remove the air from the tube, then insert the cervical tube in the direction of the uterine cavity, and tighten the cervical forceps to make the tapered rubber tip of the catheter tightly fit against the cervix to prevent leakage during injection.

4, contraction or tubal spasm, acupuncture Hegu, Neiguan acupoints or intramuscular injection of drugs, 24 hours and then take a third film at the same site, observe the abdominal cavity for free iodized oil. See clear-bounded iodine mass, consider fallopian tube adhesion. If bilateral fallopian tubes are not open, there is no diffuse oil image in the pelvis. If there is a small amount of iodine oil image with residual fallopian tubes, consider fallopian tubes.

Drain the urine and place the bladder lithotripsy in a supine position. Make

Palmer (1960) reported that multiple HSG showed that the fallopian tube was unobstructed, and the pregnancy rate within one year was as high as 76%, which was three times higher than that of those without HSG.

The therapeutic effect of HSG on infertility may be due to:

(1) The injected contrast agent has a mechanical flushing effect on the fallopian tube.

(2) The traction effect on the cervix during angiography may break some slight adhesions around the fallopian tube.

(3) Iodine oil is thick and easy to emulsify, and can be evenly coated on the surface of the fallopian tube mucosa, which can fully exert the local bactericidal effect of iodine.

(4) can improve cervical mucus environment.

(5) Iodized oil can slow down the phagocytosis of monocytes in in vitro experiments, and may reduce the phagocytosis of monocytes on sperm in vivo.

The effects of tubal angiography are small and almost non-existent, but some contraindications need attention. Before the imaging, if the preparation is not enough or the operation is improper, this will cause the female tubal angiography side effects to appear.

For aseptic operation, it can effectively avoid the side effects of tubal angiography. After the angiography, it is necessary to ban the bath and sex for two weeks. After the operation, pay attention to give antibiotics as appropriate to prevent infection. The examiner's abdominal pain is also a side effect of tubal angiography, but it is usually within the acceptable range of the patient. After the angiogram, the patient will have a small amount of bleeding from the vagina, usually within 3-5 days. This is normal if there are no other symptoms.

1. Fallopian tube angiography is the injection of contrast agent into the uterus and fallopian tubes, and monitored under the X-ray machine. This will cause the body to absorb some X-rays. However, the damage caused by transient X-ray irradiation is slight and reversible. For routine X-rays, pay attention to protection, but not fear.

2. X-ray tubal angiography is an iodine contrast agent. The density of 40% iodinated oil is large and the development effect is good, but the irritation is strong. Postoperative abdominal pain is severe and sometimes causes chemical peritonitis. The examination time is long and the absorption is slow, which is easy to cause Foreign bodies react to form granulomas. If a large amount enters the vein, there is a danger of causing oil plugs.

Does tubal angiography hurt? ^[2]

1. Uterine factors: The patient has uterine diseases, such as uterine fibroids, congenital uterine smallness, uterine cavity adhesion, or too tight cervical mouth and uterine flexion, etc., which makes it more difficult to intubate, so Slower, if inexperienced, even radiography can not be made.

2. Doctor's proficiency: it plays a decisive role in angiographic pain. Tubal angiography is a professional check of the degree of tubal patency. Only specialized infertility can have more disease materials.

3. Coordination of patients: Some patients do not cooperate with the doctor, and sometimes feel shy, embarrassed, etc., which seriously affects the operation of the doctor, so the speed becomes slower.