He and his associates compared 200 premenopausal women who had endometrial thickness measurements taken before having a sonohysterogram (SHG) to investigate abnormal uterine bleeding.
It's probably better to do an ultrasound to assess the overall morphology of the endometrium and then perform a sonohysterogram in virtually all patients, unless it's completely obvious that there's something there," Dr.
Similarly, an observational prospective cohort study of 225 women who had undergone a cesarean section 6-12 months prior compared TVUS and gel-infused sonohysterogram
(GIS) and found that the prevalence of a niche--defined as an anechoic area at the site of the cesarean scar, with a depth of at least 1 mm on GIS--was 24% with TVUS and 56% with GIS (Ultrasound Obstet.
The initial work-up for a postmenopausal patient should begin with a pelvic examination, followed by an assessment of her endometrial cavity by transvaginal ultrasound (TVUS), saline infusion sonohysterogram
(SIS), or biopsy.
Using only 2D imaging, neither an unenhanced sonogram nor a sonohysterogram
can provide definitive information regarding the possibility of a uterine anomaly.
was done which showed ballooned out cervix with obliterated uterine cavity suggestive of dense adhesions (Fig.
Although the saline infusion sonohysterogram
is far better for evaluating uterine leiomyomata than is the hys-terosalpingogram, the technique does not allow evaluation of the fallopian tubes.
(Figure 1) shows an obvious submucous myoma, which was removed (hysteroscopy--resectoscope passed, fibroid looped at base).
Prior to performing the procedure, the size of the cavity can be demonstrated using sounding, hysteroscopy, or saline sonohysterogram
I don't care how good an ultrasonographer you are, you can't rule out mucosal or submucosal involvement of fibroids just on the basis of ultrasound unless you perform a sonohysterogram
, which was not done in this study.
Be sure to schedule the sonohysterogram
at the tail end of the bleeding, when the endometrium is in its thinnest and most uniform state.
For this reason, I use a finer, single-tooth tenaculum designed for use with sonohysterograms
(Goldstein Grasp Cervical Stabilizer).