hysterosalpingogram (HSG)

• Assess morphology of endocervical canal, uterine cavity, tubes.
• Rule out tubal occlusion, synechiae, uterine anomalies.

Indications

1. routine infertility evaluation
2. repeat abortions
3. PID with tubal involvement
4. post-surgical evaluation
5. lost IUD
6. abnormal uterine bleeding
7. incompetent cervical os

Contraindications

1. active PID with abdominal tenderness or palpable mass
2. recent uterine/tubal surgery
3. active uterine bleeding
4. pregnancy (schedule exam before ovulation to avoid early pregnancy)

Complications

1. pain and discomfort (worse with tubal disease)
2. injury/bleeding from minor tissue tear
3. contrast reaction
   • systemic
   • local mucosal irritation & focal granulation
4. intravasation
   • reticulated collection with opacification of venous structures (esp ovarian/iliac v. and lymphatics)
5. pelvic or systemic infection
6. pregnancy-related complications
   • disruption
   • fetal damage
   • induce extrauterine pregnancy

© 2002, C.E. Kahn, Jr.
2002-04-18