Hysterosalpingography is an invasive procedure, that is, for its production, it is necessary to penetrate instruments into various organs and body cavities. It is the invasiveness of hysterosalpingography that is the factor that underlies the possible consequences and complications of manipulation. The entire set of possible consequences of hysterosalpingography is divided into early and late ones. Early complications arise directly during the procedure itself and within a few hours after it. Late complications of hysterosalpingography develop 1 to 3 days after manipulation.

Early complications of hysterosalpingography include the following conditions:

• Vascular reflux, resulting from the penetration of a radio-opaque substance into the capillaries and veins of the uterus;


• Lymphatic reflux, resulting from the penetration of a radiopaque substance into the uterine-tubal lymphatic vessels or into the wide ligament of the uterus located in the abdominal cavity;


• Perforation of the uterine wall (rupture of the organ wall with an instrument);


• Rupture of the fallopian tube due to the strong pressure of the pumped liquid;


• Allergic reactions to radiopaque substances.

Late complications of hysterosalpingography include the following conditions:

• Exacerbation of a chronic infectious process in the pelvic organs;


• Infection of the uterine cavity, fallopian tubes and ovaries with contaminated instruments with the development of an acute infectious and inflammatory process in the small pelvis.

Side effects of hysterosalpingography include the following body reactions:

• Light blood anesthesia for 1 to 7 days. If heavy bleeding develops or lasts longer than a week, you should see your doctor;


• Mild pains in the lower abdomen, similar to menstrual periods. Pain usually appears at the time of injection of a radiopaque substance into the uterine cavity and can last for a day. If the pain persists for more than 2 days after the manipulation, you should consult a doctor;


• When fluid is pumped into the uterine cavity, a woman may experience nausea and dizziness, which will pass after a while;


• After the procedure, the temperature may rise slightly, remaining elevated for 1 - 2 days;


• General malaise within 1 to 2 days after the procedure.

The HSG (hysterosalpingography) of the fallopian tubes is one of the types of gynecological diagnostic research. The technique provides the doctor with reliable data on the state of the reproductive organs.

According to the method of conducting, the study is divided into X-ray and ultrasound. Modern ultrasound GHA is considered a more effective and safer procedure for women's health than the standard X-ray type of examination.

What is HCG in gynecology?

The procedure is an X-ray of the uterus and fallopian tubes. The aim of the study is to determine their patency and diagnose the physiological state of the uterus in women. In most cases, the procedure is prescribed with an established diagnosis of infertility and recurrent miscarriage.

Ultrasound hysterosalpingography

Modern medical equipment makes it possible to conduct research without the use of X-ray radiation. Ultrasound hydrosonography is performed using sterile saline, which is injected into the uterine cavity using a soft hysterosalpingography catheter.

The saline solution enters the uterine cavity and fills the fallopian tubes. The doctor evaluates this process and controls it using a transvaginal ultrasound probe. Ultrasound helps determine if fluid is flowing freely in the tubes. Fluid will not spread properly if there are obstacles and poor passability.

Pros of ultrasonic GHA:

• painlessness and physiology;
• absence of harmful effects of X-ray radiation on ovarian follicles;
• lasts about half an hour, which allows you to best assess the condition of the fallopian tubes;
• does not cause individual reactions and allergies.

Indications and contraindications for diagnostics

The indications for the procedure are the following pathologies:

• suspicion of infertility;
• endometriosis and endometrial hyperplasia;
• physiological malformations of the vagina, cervix, uterus itself and appendages;
• isthmicocervical insufficiency.

Contraindications:

• the presence of an acute infectious process;
• heart failure;
• thrombophlebitis;
• renal and hepatic impairment;
• hyperthyroidism, impaired thyroid function;
• inflammatory process in the uterus and appendages;
• acute inflammation of the vagina and vulva (colpitis, vulvovaginitis);
• unfavorable blood test (increased leukocytosis, increased erythrocyte sedimentation rate);
• unfavorable urine analysis;
• individual intolerance to iodine;

An absolute contraindication is the period of pregnancy and lactation.

On what day of the cycle is the hysterosypingography performed?

The exact time for the procedure depends on the purpose of the study. To confirm the diagnosis of endometriosis, the procedure is prescribed on the 7-8 day of the cycle. To determine the degree of patency of the fallopian tubes, the examination is prescribed for the second phase of the cycle. In any phase of the cycle, the GHA can be performed in order to detect the presence of uterine fibroids.

The most optimal time to conduct a study is the first two weeks after menstruation. During this period, the endometrium is still thin enough to provide free access to the mouth of the fallopian tubes.

Preparation for hsg fallopian tubes

The GHA method is safe and low-traumatic, but refers to invasive procedures, therefore, requires special training. Preparation for hysterosalpingography includes the following steps:

• it is necessary to undergo a general gynecological examination and pass tests for hysterosalpingography: a bacteriological smear from the vaginal mucosa is necessary to make sure that there are no genital infections;
• to diagnose other infectious diseases, it is necessary to take blood tests;
• during the week before the examination, you cannot use vaginal suppositories and suppositories, sprays, douching solutions and intimate hygiene products;
• for two days before the study, you should refrain from sexual intercourse;
• sometimes the doctor prescribes allergy tests for the contrast agent used in the X-ray form of the study;
• if the procedure is carried out in the second phase of the cycle, a pregnancy test is performed.

Diagnostic technique

Before the procedure, a woman must undergo a regular gynecological examination with mirrors.

The procedure does not take too long. After examination, a special tube (soft catheter) is inserted into the cervix. Through this tube, the doctor uses a syringe to inject a contrast agent for X-ray examination into the uterine cavity. After a while, when the contrast fluid enters the tubes, the doctor takes x-rays showing the condition of the fallopian tubes.

The liquid for research is absolutely safe for health. It is excreted without a trace from the patient's body, absorbed into the bloodstream, without requiring any additional procedures to cleanse the uterus.

Is it painful to do the GHA fallopian tube procedure?

Many women wonder if the research will be painful. The procedure is considered a painless, minimally invasive diagnostic method, so anesthesia or local anesthesia is not required before the procedure. In some cases, local anesthesia with lidocaine is used if the patient does not have an individual intolerance to the anesthetic.

During the procedure, you may experience discomfort, reminiscent of menstrual pain in the lower abdomen. An hour after the end of the examination, they disappear.

Video: "How is hysterosalpingography done and what are the advantages of diagnosis?"

Results of the procedure

X-rays show how the contrast agent passes through the fallopian tubes. If fluid has filled the tubes and entered the abdominal cavity, the doctor makes sure that the fallopian tubes are patent. In the event that the liquid has not completely penetrated the pipes and has stopped at a certain level, the specialist confirms the presence of obstruction and prescribes further treatment.

If the study was carried out correctly, it is quite informative and allows not only to confirm or deny the presence of obstruction, but also to identify various intrauterine pathologies.

Consequences and complications of hsg fallopian tubes

Complications and consequences after the procedure are rare. One of the types of possible complications is an individual allergic reaction to the contrast fluid with which the procedure is performed. If the examination technology is violated, inflammation of the appendages may begin.

As for X-ray irradiation, its doses during examination are so small that they do not cause any harm to women's health.

Some experts note that pregnancy after the GHA of the fallopian tubes is easier, and the procedure increases female fertility, contributing to the rapid conception of a child.

Recovery after the GHA

For a couple of days after the procedure, the patient may experience minor bleeding from the vagina. Discharge is associated with trauma to the cervix and is most often observed in women with cervical erosion.

Minor pains in the lower abdomen disappear quickly enough without requiring additional pain relief.

Estimated cost of hysterosalpingography

It is best to find out how much the GHA of the fallopian tubes costs directly at the medical institution where hysterosalpingography is performed. On average, the cost of the procedure varies between 4000-8000 rubles (150-250 dollars), depending on the clinic.

Today, X-ray GHA of the fallopian tubes is considered an outdated technique, which is increasingly being replaced by high-tech ultrasound and computer. In combination with other diagnostic methods, the procedure allows you to quickly and effectively diagnose and determine the physiological state of a woman's reproductive organs.

HSG X-ray (X-ray hysterosalpingography, RG-HSG) is a diagnostic technique designed to assess the condition of the female genital organs. The essence of the study is that a catheter is inserted into the uterine cavity through which a contrast agent is supplied. This is what will be seen during the execution of a series of X-ray images. After it is evenly distributed over the uterus and appendages, the doctor "shines through" the organs using an X-ray machine. The images will clearly show the fallopian tubes and uterus.

With the help of this procedure, it is possible to detect such pathologies of the genital organs as obstruction of the fallopian tubes, endometriotic growths in the uterus, structural abnormalities, etc. This method is often recommended for women who suffer, since the listed factors most often lead to the fact that patients cannot become pregnant ...

It is possible to perform the procedure both in an outpatient clinic and in hospitals of gynecological departments. The main condition for its implementation is the presence of an X-ray apparatus and a specialist who can work on it.

During hysterosalpingography, the woman is in the gynecological chair. After the doctor injects a contrast agent into the uterine cavity, it is necessary to hold it for some time. This will allow the fluid to be evenly distributed over the internal genitals. After that, one or more photographs are taken to assess the result.

If a woman does not have any pathologies, then the uterus looks like a triangle of regular shape, and the tubes have an arched shape. In the presence of diseases, the picture changes: it is possible to detect neoplasms (, fibroids), septa, adhesions, etc. If a woman has obstruction of the fallopian tubes, the contrast agent will be unevenly distributed, and obstacles in its path will be clearly visualized.

The procedure does not require the introduction of anesthesia, as it does not cause pain. However, if a woman has a high threshold for pain sensitivity, then local anesthesia is indicated for her.

GHA and ultrasound are the same thing?

GHA and ultrasound are two different procedures. Ultrasound examination involves a review of the patient's internal organs and the detection of possible pathology by changing their structure and density. The picture is displayed on the monitor. To conduct an ultrasound scan, there is no need to perform any additional procedures. It is enough just to lubricate the viewed surface with a special gel.

GHA involves the introduction of contrast fluid into the uterus. After its distribution, the doctor takes a series of pictures using an X-ray machine (but it is possible to examine the internal organs on an ultrasound machine). The introduction of a contrast agent allows you to make the study more informative. In addition, the doctor can diagnose obstruction of the fallopian tubes, which cannot be done during a routine ultrasound examination.

Since two devices can be used for the GHA: X-ray and ultrasound, there is a difference in the course of diagnostics. If the images are taken with X-ray equipment, the procedure is called X-ray hysterosalpingography. When an ultrasound machine is used to perform the study, the technique is called "echohysterosalpingography". Due to the similarity in the name, many people believe that these procedures are identical, in fact, their essence and diagnostic value differ.

Which is better: X-ray or GHA?

Standard X-ray examination will not reveal obstruction of the fallopian tubes or other pathologies of the pelvic organs, so it is never used for this purpose. GHA, on the contrary, is the method of choice for suspected obstruction of the fallopian tubes, endometrial polyps, uterine fibroids, and other pathologies of the female reproductive system. Therefore, the GHA is definitely better than X-ray.

However, it should be understood that the GHA is performed either with the help of an X-ray apparatus or with the help of an ultrasound diagnostic apparatus. The internal genital organs of a woman become visible on them after the introduction of a special contrast agent into the uterus and fallopian tubes. Many experts use the term "X-ray" to denote the procedure for examining the fallopian tubes on an X-ray machine, and the term "GHA" - to conduct a study on an ultrasound machine. If we consider the issue from this point of view, the GHA will be better than X-ray.

The fact is that Echo-GHA has the following advantages over the GHA:

A woman will not have to use contraceptive methods that protect her from pregnancy if she was prescribed an ultrasound GHA.

There are no contraindications for conceiving a child in the month when the Echo-GHA was performed.

During and after the procedure, there is no risk of an allergic reaction to a contrast agent that contains iodine.

The patient's body will not be irradiated by the X-ray machine. Moreover, this negatively affects the number of eggs that are in the ovarian follicles (ovarian reserve).

GHA of the fallopian tubes is carried out by gynecologists and gynecologists-oncologists.

The indications for the appointment of the procedure are as follows:

Tubal infertility;

Adhesions of the pelvic organs;

Anomalies in the development of the reproductive organs;

Sexual infantilism;

Hysterosalpingography is the method that will confirm that a woman has a pathology of the fallopian tubes or uterus, but does not always make it possible to assess the severity of the disease and its nature. If we turn to statistics, then in 98% of cases it is possible to identify the existing violation, but the correct diagnosis is obtained only in 35% of cases.

X-ray hysterosalpingography may not always be performed.

There are certain contraindications to the procedure, including:

Intolerance to iodine preparations. This contraindication is due to the fact that the composition of the contrast agent, which is injected into the uterine cavity, contains iodine.

Inflammation of the ovaries, uterus, appendages.

Blood clotting disorder.

Heart disease.

Expressed disorders in the liver.

Thyroid pathology.

Pregnancy. A pregnancy test is mandatory before undergoing the procedure.

Menstrual bleeding.

Lactation.

Increased ESR and leukocytosis.

Preparation for the procedure is not difficult, but the implementation of the recommendations given by the doctor is a prerequisite. Otherwise, you can harm your own body.

So, a woman must observe the following rules in order to properly prepare for hysterosalpingography:

1-2 days before the proposed study, you need to give up intimacy.

7 days before the procedure, do not douche or use intimate hygiene products inserted into the vagina.

7 days before the study, it is forbidden to use vaginal tablets, suppositories and ointments for treatment.

2-3 days before the study, you need to change your diet, giving up the use of foods that provoke excessive gas formation. This applies to cabbage, legumes, bread, dairy drinks, soda water.

You should stop using tampons 7 days before the procedure.

After another period ends, partners should use a condom to avoid conception.

It is equally important to undergo a high-quality examination before conducting the GGS. It necessarily includes the delivery of the following tests:

Blood test for syphilis, HIV,.

A smear from the vagina and from the cervix.

Before you go to the procedure, you need to remove all hair from the external genital organs, wash them thoroughly. The bladder and intestines should be empty. If it was not possible to go to the toilet, then an enema should be done. The procedure should be performed on an empty stomach.

As for the self-administration of painkillers, it is prohibited to use medicines without consulting a doctor. According to the doctor's prescription, it will be possible to drink an antispasmodic, for example, No-shpu, 30 minutes before the GHA.

What is the time frame for the GHA?

Most often, hysterosalpingography is performed within 2 weeks after the next menstruation. This is due to the fact that during this period the mucous membrane of the uterus has a small thickness, which means that it does not block the entrance to the fallopian tubes.

Although, depending on the purpose of the study being carried out, it may be appointed at other times. To assess the patency of the fallopian tubes, it is carried out in the second half of the menstrual cycle. If there is a suspicion of internal endometriosis, it is recommended to perform HGS on days 7-8 of the cycle. Myoma in the submucous layer of the uterus can be detected at any time, but only if the woman does not have menstruation.

How is the GHA carried out?

If the doctor's office is equipped with a special X-ray chair, then the woman is seated on it. If there is no such chair, then the patient will sit on an ordinary gynecological chair, and an X-ray machine will be brought to her.

After treating the external genital organs with an antiseptic composition, the doctor inserts mirrors into the vagina and wipes the vaginal walls, first with dry cotton wool, and then moistened with an alcohol solution. The next step is to place the tube with fixation in the cervical canal. The tube is secured with bullet pliers. When this manipulation is done, the mirrors are removed. A contrast agent is supplied through the tube with a syringe, which must first be warmed up to approximately the woman's body temperature (up to 37 ° C).

When the contrast agent is evenly distributed throughout the uterine cavity and fallopian tubes, the doctor begins to take pictures. As a rule, the doctor takes from 4 to 6 pictures during the procedure. To begin with, the state of the uterus is recorded (its relief). Then another 4 ml of contrast agent is fed into the cavity, which makes it possible to more clearly visualize the appendages. If this volume of liquid is not enough, then inject as much as necessary.

After all the pictures have been taken, the patient is placed on a couch and left in a horizontal position for another hour. The fluid that was introduced during the procedure is absorbed into the bloodstream and excreted from the body by the liver and kidneys.

What contrast agent is used for the GHA?

For the procedure, the introduction of a contrast fluid is shown, which has the ability to delay X-ray rays. These are drugs such as:

Cardiotrust. It is a contrast agent that can contain 50% and 30% iodine.

Urotrast, Triombrast and Verografin. These are three analogs belonging to the group of radio-opaque substances, which can contain 60% and 76% iodine.

It is interesting that for the first time they tried to carry out hysterosalpingography with Lugol's solution in 1909. But because of the irritation of the peritoneal cavity and uterus, this attempt was unsuccessful. A year later, the lugol solution was replaced with bismuth paste, and then with argyrol and collargol. However, it was not possible to achieve the desired effect using these substances. In addition, they all entailed inflammatory processes of the peritoneum.

Only in 1925, the scientist Heuser first used Lipiodol (a preparation containing iodine) for hysterosalpingography. This substance made it possible to visualize well the state of the uterus and fallopian tubes, and also did not harm the woman's health. It was since then that the procedure was introduced into medical practice.

Consequences and complications of the GHA

A woman should use sanitary napkins for 2-3 days after the procedure. This need is due to the fact that residues of the contrast agent can flow out of the vagina. If a small amount of blood is found in the discharge, then you should not worry about this, since such a phenomenon is a variant of the norm.

Mild painful sensations, reminiscent of those that occur during the next menstrual cycle, should not scare a woman. After the GHA, such discomfort does not indicate any complications.

Also, the patient should be prepared for the fact that during or several hours after the HSG, a metallic taste in the mouth, dizziness, and increased heart rate may occur. This is a normal reaction of the body to the administration of a contrast agent.

A woman should not visit a sauna or bathhouse, as well as take a hot bath for 3-4 days after passing the GHA.

If your body temperature rises, bleeding profusely, or severe pain in the lower abdomen, you should be worried and see a doctor immediately.

Extensive blood loss, infection, perforation of the uterus and fallopian tubes during the GHA procedure are extremely rare in modern gynecological practice, as an exception.

A woman should refrain from becoming pregnant for the next 3 months. For protection, use a condom.

As a rule, the procedure is well tolerated, but only on condition that the preparation for it was carried out with high quality: inflammatory processes were detected on time, there are no other contraindications to the GHA.

The doctor should interpret the results based on the images obtained.

The signs of various diseases on the X-ray picture are as follows:

Noticeable asymmetry of the uterus - the diagnosis is "one-horned uterus".

An elongated cervix and a pronounced decrease in the volume of its cavity is the diagnosis of "infantile uterus".

Short, long, or asymmetric fallopian tubes - the diagnosis is "congenital obstruction of the fallopian tubes."

The presence of a bulbous expansion in the tubes is a possible diagnosis of "adhesions of the fallopian tubes", or "sactosalpinx", or a combination of these two diagnoses.

The presence of light areas in the tubes - "adhesions of the fallopian tubes."

The shape of the fallopian tubes, which resembles the shape of smoking pipes, the presence of extensions in the form of a bulb, a decrease in the volume of the uterine cavity - the diagnosis is "tuberculosis of the genitals."

The uneven contours of the uterus, the identification of defects of an oval or other shape - the diagnosis of "uterine polyps" or "endometrial hyperplasia".

Of course, only the most obvious and common signs of certain diseases were listed. Only the attending physician can make a final diagnosis, evaluating the whole complex of results obtained in the course of various studies.

GHA cons

The disadvantages of the procedure include the following points:

A woman's dose of radiation, albeit a small one.

The likelihood of an allergic reaction to the contrast medium being administered. Women with a history, as well as allergic patients, should be particularly careful.

There is a risk of mechanical damage to the epithelial layer of the uterus, which leads to the appearance of bloody discharge.

GHA advantages

In addition to the fact that the X-ray GHA is highly informative, it has another important advantage. The fact is that hysterosalpingography is not only a diagnostic, but also a therapeutic method of influencing the female body. It has been established that approximately 20% of women suffering from infertility, after passing the GHA, successfully become pregnant.

Doctors explain this fact by the fact that during the procedure it is possible to improve the patency of the fallopian tubes, since the injected substances "wash" them, eliminating small adhesions.

Education: Diploma in Obstetrics and Gynecology was obtained from the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N.N. N.I. Pirogova.

It is one of the most informative in the diagnosis of diseases of the pelvic organs. HSG, or hysterosalpingography, is another additional imaging method that allows you to get a more complete picture of the anatomical and functional state of the uterine cavity and fallopian tubes. It is especially widely used to diagnose the causes of infertility.

Preparation for hysterosalpingography

Timing of the procedure depend on the presumptive diagnosis and the purpose of the study. To assess the patency of the fallopian tubes, as well as to clarify the presence or absence of internal endometriosis and adenomyosis, the GHA is performed on the 5-8th day of the menstrual cycle, in case of suspicion of isthmic-cervical insufficiency - in its second phase (on the 18-20th day). Diagnosis of the volume and boundaries of the submucous (under the mucous membrane) myomatous node is carried out on any day of the menstrual cycle, provided there is no abundant discharge of blood from the genital tract.

Indications and contraindications

Indication to hysterosalpingography is the assumption of the presence of:

1. Isthmico-cervical insufficiency - expansion of the cervical canal and its internal pharynx up to 5-7 mm.
2. Abnormalities in the development of the uterus and appendages.
3. Submucous fibroids or synechiae (adhesions in the uterine cavity).
4. Adenomyosis, endometrioid cancer, polyps, genital tuberculosis.

One of the preparation stages is the examination of the patient by a gynecologist and preliminary studies in order to determine not only the indications, but also contraindications for the GHA.

Contraindications:

1. Assumption of the possibility of pregnancy.
2. Pregnancy and breastfeeding.
3. Bloody discharge from the genital tract.
4. Acute infectious diseases.
5. The degree of cleanliness of the vagina is lower than II degree and acute inflammatory processes of the genitals or urinary tract - bartholinitis, vaginitis, cervicitis, salpingo-oophoritis, urethritis, cystitis, pyelonephritis.
6. Severe chronic somatic diseases.

• cessation of the use of vaginal remedies and douching 7 days before the study, if they are not prescribed by a doctor, and within 3 days after the procedure;
• refusal of sexual intercourse or the use of contraception during the menstrual cycle, during which the examination is planned;
• lack of sexual intercourse for 1-2 days before the procedure and 2-3 days after the study;
• exclusion from the diet of foods that promote gas formation in the intestine, 3-4 days before the study, cleansing enemas the night before and in the morning of the procedure.

Hysterosalpingography is normal

How the research is done

The method exists in the form of two options, depending on the equipment used - radiopaque (Rg-GHA) and sonographic, or ultrasonic (Uz-GHA). In any case, hysterosalpingography is performed on an empty stomach without the use of anesthesia.

The procedure may cause discomfort in the examined patient, discomfort in the lower abdomen and slight soreness. Therefore, with psychoemotional instability and high excitability, fear of the procedure, and at the request of the woman, it is possible to administer sedatives or to carry out adequate general intravenous anesthesia.

The study is carried out on a gynecological chair. After preliminary examination and anesthesia (if necessary), a special balloon catheter about 35 cm long and with a lumen diameter of 0.2 cm is inserted into the cervical canal.It is equipped with a cone-shaped balloon, which ensures tightness in the area of \u200b\u200bthe external os of the cervix.

Through the outer end of the cannula, 2.5-3 ml of a radiopaque or echocontrast solution is injected into the cervical canal with a syringe and an X-ray image or an examination on the screen (in the case of Uz-HSG) of the inner surface of the uterine cavity is performed. Then, about 4 ml of contrast solution are injected, which achieves tight filling of the uterine cavity and the exit of the solution through the fallopian tubes into the pelvic cavity (to check the patency of the tubes). This is also recorded by a snapshot or inspection. If necessary, control is carried out by repeated administration of another 3-4 ml of solution. The total amount of the latter is 10-20 ml.

In order to diagnose isthmic-cervical insufficiency and find out its cause, adrenal progesterone test ... When conducting the HSG on the 18th day of the menstrual cycle, the sharply narrowed cervical canal and its internal pharynx are normally determined. If they are expanded, the named test is carried out.

It helps to establish whether violations are organic or functional. The essence of the test is the subcutaneous injection of 0.5 ml of 0.1% adrenaline. In 5 minutes after that, the control GHA is performed. If the narrowing of the cervical canal did not occur, then in the evening of the same day, hydroxyprogesterone capronate (0. 125 g) is injected into the muscle, followed by repeating the previous procedure after 4 days.

With functional cervical insufficiency due to insufficiency of the corpus luteum, after correction of it with oxyprogesterone, a sharp narrowing of the canal occurs, in the case of an organic cause of its expansion, it remains the same.

Thus, ultrasound hysterosalpingography and X-ray HSG are almost the same in technical performance. In terms of information content, they are also equivalent. The main difference between the methods is:

1. Contrast solutions used. In the case of Uz-GHA, an echocontrast solution is used that does not cause allergic reactions - a 10% glucose solution or an echovist, which is a galactose granulate in a vial. It is dissolved immediately before the study to a 20% suspension with a solvent attached to the drug. For the X-ray GHA, iodine-containing X-ray contrast agents are used - Verografin, Triombrast, Urotrast or Cardiotrast. Their introduction should be preceded by a sensitivity test, since any of these drugs can cause a severe allergic reaction.
2. The degree of exposure to physical factors (radiation). Uz-GHA is based on the use of the effect of ultrasonic waves, which do not have a negative effect on the genitals. Despite the fact that a small dosage of X-rays is used to conduct Rg-HSG, nevertheless, with repeated images, it has a cumulative biological effect on the ovaries. Therefore, trying to conceive is recommended only after the menstrual period following the study.

Consequences of hysterosalpingography

In some women who have undergone the GHA, the onset of the first menstruation after the procedure occurs at a later date than usual, with the subsequent restoration of the previous cycle. Such a delay after hysterosalpingography, usually not exceeding several days, is apparently associated with psychoemotional stress and mechanical interference with the function of the genitals.

The GHA is an exclusively diagnostic, not a therapeutic method. Nevertheless, many patients who were examined for infertility report the onset of pregnancy in the next 3 months after the study.

There is no scientific explanation for this. Some doctors associate pregnancy after hysterosalpingography with the introduction of an oil solution of a radiopaque substance, which supposedly improves the function of the villous epithelium of the mucous membrane of the tubes and destroys "loose adhesions", which is unlikely.

More convincing is the assumption of mechanical washing with a solution of a contrast agent of mucus that forms on the mucous membrane of the walls of the fallopian tubes in the presence of a sluggish inflammatory process that was not previously diagnosed. As a result, the patency of the tubes and the function of the villous epithelium are restored for some time.

Another assumption is the short-term correction of the function of the corpus luteum with oxyprogesterone during the adrenal-progesterone test.

After the HSG, unpleasant sensations in the lower abdomen may persist for 1-2 days, minor bloody and / or mucous discharge may appear. If the procedure was carried out against the background of a chronic inflammatory process, an exacerbation of the disease is possible.

At the same time, hysterosalpingography in most cases does not cause any serious consequences and is a highly informative additional method in the diagnosis of a number of diseases and causes of infertility in women.

The most informative diagnostics in gynecology is ultrasound. Another additional research method that helps to obtain all the necessary information about the uterine cavity is the HSG - hysterosalpingography. Most often, this procedure is used when it is necessary to establish the cause of infertility. The most common pathology in the area of \u200b\u200bthe fallopian tubes is considered, which can be identified during this study.

In contact with

Today, many are interested in what hysterosalpingography is, since the problem of infertility is urgent. This is a survey method that checks if in what condition are the fallopian tubes and.

The research process itself consists in the fact that the listed organs are filled with a special substance that gets there through the vagina when using a catheter. After that, either X-ray or ultrasound is used, with the help of which a specialist can study in detail what position the organs are in.

A special substance helps to see formations, inflammation, adhesions. And also this method helps to fix whether the contrast agent can enter the abdominal cavity through the fallopian tubes. If special fluid can pass through the fallopian tubes, it means that they the condition is normal, and the patency has no violations.

There are two types of GHA:

• x-ray,
• echohysterosalpingoscopy.

If it is decided to use an X-ray, then here the contrast liquid is injected in specially designated portions, and the specialist gradually takes several pictures. During ultrasound physiological solution is injected into the organ, with the help of which an additional action is carried out, which consists in breaking small adhesions. This leads to the fact that after carrying out this type of GHA, a woman can become pregnant. But this only happens if the problem was

It is quite difficult for patients to understand what kind of diagnostic method it is, therefore, before deciding to undergo the GHA, one should consult a doctor, since the procedure has a number of contraindications.

The GHA process

GHA Conducting

Before deciding on this procedure, you should familiarize yourself with how this study is carried out. So, a woman should lie on the couch when using an X-ray or ultrasound. But in the first case, the device is located above the patient, and in the second, a special vaginal sensor is used. First, the doctor must treat the genitals and cervix with an antiseptic and only after that he inserts the catheter.

Since with such a diagnosis, fluid is injected into the organs, therefore, the question often arises whether it is painful to do the GHA. Most often this process is painless, but in some cases women feel discomfort when inserting a catheter and substances.

The feeling is similar to the pulling pain that occurs at the beginning of menstruation. Slightly harder for those who have not yet given birth, as they have a tight cervix and the catheter will be difficult to advance.

If the patient feels severe discomfort during the first days of menstruation and is very worried about the examination, then she can contact the doctor for local anesthesia. You can take a drug on your own that will help relieve pain, since spasmodic organs can give a distorted result.

This procedure will last no more than 40 minutes, while removing the contrast fluid from the tubes will take a significant part of the time. After the examination is completed, the woman needs spend some time in the ward, this will eliminate the appearance of bleeding. You should be aware that after the GHA can arise directly from the vagina.

Preparation for research

To get accurate results, preparation for the GHA of the fallopian tubes must be correct. This will not be difficult, but for a start it is important that the specialist determines on what day the examination should be carried out, and after that it is worth following several recommendations.

To obtain reliable research results, doctors advise:

1. The day before the GHA diagnosis, do not have sexual intercourse.
2. It is important to stop using cosmetics for intimate hygiene within 7 days.
3. Washing should only be done with warm water.
4. Do not douche.
5. Do not use vaginal medications.

Note!Preparation for the GHA fallopian tubes does not imply adherence to a special diet before the procedure.

It is also important to familiarize yourself with the day of the cycle doing such a procedure. As a rule, this diagnosis is prescribed in, because during this period the epithelium covers the uterus thinner than at the beginning of menstruation. In this case, the entrance to the pipes will not be blocked, due to which the images will be more informative. Therefore, if there is a question about planning the GHA on which day of the cycle, it is on 7 or 10 days.

The doctor will prescribe everything to prepare for the procedure

Analyzes for the GHA

To conduct the GHA, it is necessary to pass tests for the study, which should be as follows:

• blood taken from a vein to check for syphilis, HIV, hepatitis;
• general blood and urine tests;
• smear to determine the state of microflora.

All of the listed studies for the GHA fallopian tubes have an expiration date. So, blood tests from a vein for the listed diseases valid only for 3 months, general analyzes - up to 5 days, smears - up to 7 days. Hysterosalpingography is only permitted if the results for syphilis are negative and the overall readings are normal.

If the examination is scheduled at the beginning of the cycle, then smears should not be taken immediately after the end of menstruation, since at that time there may be an increased number of leukocytes, which enters the vagina with the flowing blood.

Blood test

Consequences and complications

The GHA has contraindications, which can be absolute and relative. The former are permanent, while the latter can be temporary, and if some factors are eliminated, then in the future, such a study is possible.

The absolute contraindications include:

• an allergic reaction to contrast fluid or iodine;
• period of pregnancy;
• heart failure;
• kidney or liver disease.

Relative contraindications may be as follows:

• acute viral or infectious process;
• inflammation that is localized in the uterus;
• inflammatory process in the vagina;
• hyperthyroidism;
• negative test results, which may indicate an increased rate of leukocytes, mucus and erythrocytes in the urine.

Despite the fact that hysterosalpingography is a safe diagnosis, nevertheless highlight a number of consequencesto which it can lead. So, after the procedure, a woman may experience discharge with mucus or blood in an insignificant amount for about 4 days.

Groin pain is common and may soon go away on its own. To stop these unpleasant sensations, you can take no-shpu. When the consequences of the GHA fallopian tubes are still present, then for some time you should not visit the pool, bathhouse. We'll have to refrain from intercourse.

Complications after the procedure are also possible, which can manifest themselves in the form of acute or chronic endometritis. It can occur due to an infection entering the uterus. Also the patient bleeding from the vagina may occur, which appears if the examination is carried out by an unqualified doctor. If there is pain that does not go away for a long time, discharge, a fetid odor, or a fever, then you should seek help from a doctor.

Note!If the consequences of the GHA of the fallopian tubes manifested itself in the form of secretions, then only a gasket can be used. It is strictly forbidden to use tampons or to douche.

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