Transabdominal Saline Contrast Sonohysterography: Can It Replace Hysterosalpingography In Low Resource Countries?

Abstract

Objective: The objective of the study was to assess the accuracy of transabdominal saline contrast sonohysterography (TASCSH) compared to Hysterosalpingogaphy (HSG) in an (our) environment where the gold standard modalities are not readily available. Study Design: One hundred consecutive patients referred to the radiology unit for Hysterosalpingography and who gave consent for TASCSH as well HSG were included in the study. Sensitivity specificity, positive and negative predictive values of TASCSH were calculated using the widely used HSG as the gold standard. Results: TASCSH had 100% sensitivity, specificity and positive predictive value for uterine synechiae, hydrosalpinges and bilateral tubal blockade but 31% sensitivity for unilateral tubal blockade. TASCSH also showed 100% concordance with HSG in submucous masses (polyps & Fibroids) and found to be less painful by 80% of the patients. Conclusion: The readily available, easy to interpret TASCSH is not only safer and cheaper but it’s as accurate as HSG in evaluating the fallopian tubes and uterine cavity in infertile patients. We advocate its use as replacement for HSG in environment like ours where Hysteroscopy, MRI, positive contrast sonohysterography, transvaginal probes and skill are not readily available.

Keywords

• transabdominal
• saline contrasts sonohysterography
• hysterosalpingography
• infertility
• developing countries