Hysterosalpingography

It is very necessary for women to conduct daily check-ups now, because this way they can detect abnormal lesions in the body as early as possible and prevent the disease from further deteriorating. There are many different ways for girls to check their pregnancy. In addition to X-ray and B-ultrasound, another common method is hysterosalpingography. However, people don’t know much about this. In order to help everyone choose the right way to check their pregnancy, today we will introduce what this is.

Hysterosalpinography (HSG) was first used in the 1920s. It involves injecting iodine, a high-density substance with a high atomic number, into the uterine cavity through the cervical canal. This creates an obvious artificial contrast with the surrounding tissues under X-rays, allowing the lumen to be visualized, thereby understanding the conditions inside the uterus and fallopian tubes. Angiography can not only indicate whether the fallopian tubes are unobstructed and the location of obstruction, but also observe the morphology of the uterine cavity. This type of examination is relatively safe, does not require anesthesia, does not cause obvious pain, and is acceptable to patients.

Contrast agents

(1) Iodized oil: Commonly used are 40% iodized oil (domestic) and 30% ethiodol oil. The advantages of oils are: high viscosity, high density, clear images; slow flow, more time for filming; low irritation, fewer allergic reactions, and can be done in any hospital with X-ray equipment. The disadvantage is that it is slowly absorbed and may be retained at the site of fallopian tube obstruction or in the pelvic adhesion package. Over time, the saponified oil contains fatty acids, which stimulate granulomas in tissues and aggravate or cause chronic peritonitis.

(2) Iodine water: Commonly used ones are 60% or 75% diatrizoate. Other new iodine water-soluble contrast agents are expensive and therefore not widely used. The advantages of iodine water contrast are: low viscosity, can diffuse into the secretions of the fallopian tube, so that the obstructed lumen can be fully displayed; fast flow, complete the injection in one go; fast absorption, it is absorbed within 10 to 30 minutes of injection, and then excreted through the kidneys. The disadvantages are that it is somewhat irritating and requires appropriate addition of local anesthetics when injected; it flows quickly and disappears quickly, and sometimes the operator and the photographer do not cooperate well or lack experience, so the photo is not clear.

Preoperative care

1. The patient should refrain from sexual intercourse for 3 to 7 days after the menstruation is over.

2. Atropine 0.5 mg can be injected intramuscularly half an hour before the operation to reduce fallopian tube spasm.

3. The patient empty his bladder.

4. Iodine allergy test.

Ask if there is a history of iodine allergy. An iodine allergy test is performed half an hour before imaging. Generally, a skin scratch test is performed by applying 2.5% iodine tincture to the flexor surface of the forearm with a diameter of about 2 to 3 cm. A scratch is made on it and the redness or swelling is observed after 20 minutes. Conjunctival testing or venous testing may also be done.

Conjunctival test (conjunctival instillation method): Instill contrast agent into the conjunctiva of one eye. After 15 minutes, observe whether the conjunctiva is congested, red and swollen, and compare it with the side without drug instillation. If so, it is positive.

Intravenous test (intravenous injection method): 1 ml of 30% contrast agent of the same batch is injected intravenously. If there is no reaction after 15 minutes, it is negative. If urticaria, sneezing, chest tightness, metallic taste in the mouth, laryngeal edema, etc. occur, it is positive.

5. Patients with constipation can take laxatives orally before surgery to keep the uterus in a normal position and avoid the false impression of external pressure.