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.
Guier Chen, Wen-Chao Sun, Xiao-Yang Fei and Ding-Heng Li (2019) Venous intravasation during hysterosalpingography. Kaohsiung J Med Sci35(1):65. doi: 10.1016/j.kjms.2018.07.004
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
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 Radiol81:236. doi: 10.12659/PJR.896103
A. Ludwin, I. Ludwin and W. P. Martins (2018) Venous intravasation during evaluation of tubal patency by ultrasound contrast imaging. Ultrasound Obstet Gynecol51(1):143. doi: 10.1002/uog.17405
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