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Original research article


Venous intravasation as a complication and potential pitfall during hysterosalpingography: re-emerging study with a novel classification.

Abdurrahim DusakHatice E SoydincHakan OnderFaysal EkinciNeval Y GörükCihat HamidiAslan Bilici
Departments of Radiology and Obstetrics and Gynecology, Dicle University, Diyarbakir, Turkey
Date of Submission: 29-Sep-2013, Date of Acceptance: 15-Dec-2013, Date of Web Publication: 31-Dec-2013.
Corresponding Author:
Corresponding Author

Abdurrahim Dusak

Department of Radiology, Dicle University, Faculty of Medicine, 21280 Diyarbakir, Turkey.
E-mail: adusak@gmail.com

Corresponding Author:
Corresponding Author

Abdurrahim Dusak

Department of Radiology, Dicle University, Faculty of Medicine, 21280 Diyarbakir, Turkey.
E-mail: adusak@gmail.com

DOI: 10.4103/2156-7514.124105 Facebook Twitter Google Linkedin

ABSTRACT



Objectives: Presently, hysterosalpingography (HSG) is used as a means to evaluate women with infertility and repetitive pregnancy loss. Venous intravasation is a complication and potential pitfall during HSG and analogous procedures including hysteroscopy. The aim of our study was to assess the venous intravasation and to obtain critical information for more secure and more accurate procedures. In particular, the primary goal of the present study was to compare HSG without and with intravasation to identify differences seen on HSG and to assess the predisposing factors of intravasation. The secondary goal was to describe clinical- and imaging-based novel classification of intravasation.
Materials and Methods: This study included a patient cohort of 569 patients who underwent HSG between 2008 and 2011 at our center in the absence (control group) or presence (study group) of intravasation. Intravasation classified from level 0 (no intravasation) to level 3 (severe intravasation) was compared with preprocedural (demographic and clinical) and procedural (HSG) data. Data were analyzed using Statistical Package for Social Sciences (SPSS) statistical software.
Results: Of the 569 patients undergoing HSG, 528 showed no intravasation and 41 (7.2%) patients showed intravasation when associated with preprocedural (leukocytes, menometrorrhagia, secondary infertility, ectopic pregnancy, abortus, polycystic ovaries, endometriosis, and interventions) and procedural (pain, scheduling, endometrial-uterine nature, and spillage) parameters. Moreover, intravasation was lower in women with smooth endometrium, triangular uterus, and homogeneous peritoneal spillage. No association was found between age, tubal patency, increased pressure, and intravasation.
Conclusions: Using a novel classification method, intravasation can be observed in women during HSG and associates with preprocedural and procedural predisposing factors in subsumed conditions. This classification method will be useful for improving the efficiency and accuracy of HSG and related procedures by minimization of severe complications caused by intravasation.
Keywords: Complications, Hysterosalpingography, Novel Classification, Potential Pitfalls Venous Intravasation

Cited in 4 Documents

  1. Guier Chen, Wen-Chao Sun, Xiao-Yang Fei and Ding-Heng Li (2019) Venous intravasation during hysterosalpingography. Kaohsiung J Med Sci 35(1):65. doi: 10.1016/j.kjms.2018.07.004
  2. Yanni He, Haorong Wu, Ran Xiong, Hongmei Liu, Jiayao Shi, Jingjiao Xu, Ning Zhang and Yu Liu (2018) Intravasation Affects the Diagnostic Image Quality of Transvaginal 4‐Dimensional Hysterosalpingo‐Contrast Sonography With SonoVue. J Ultrasound Med :. doi: 10.1002/jum.14914
  3. Rohit Bhoil, Dinesh Sood, Tanupriya Sharma, Shilpa Sood, Jiten Sharma, Nitesh Kumar, Ajay Ahluwalia, Dipen Parekh, Kewal A. Mistry and Saurav Sood (2016) Contrast Intravasation During Hysterosalpingography. Pol J Radiol 81:236. doi: 10.12659/PJR.896103
  4. A. Ludwin, I. Ludwin and W. P. Martins (2018) Venous intravasation during evaluation of tubal patency by ultrasound contrast imaging. Ultrasound Obstet Gynecol 51(1):143. doi: 10.1002/uog.17405

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