Ultrasound-guided Lipiodol® hysterosalpingography: A prospective study on pregnancy and complication rates

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Australian & New Zealand Journal of Obstetrics & Gynaecology Pub Date : 2024-02-01 DOI:10.1111/ajo.13794
Glen Lo, Dana Hince, Neil Johnson, Paul L. Hofman, Jasmin Sekhon, Emmeline Lee
{"title":"Ultrasound-guided Lipiodol® hysterosalpingography: A prospective study on pregnancy and complication rates","authors":"Glen Lo,&nbsp;Dana Hince,&nbsp;Neil Johnson,&nbsp;Paul L. Hofman,&nbsp;Jasmin Sekhon,&nbsp;Emmeline Lee","doi":"10.1111/ajo.13794","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Fluoroscopic hysterosalpingography (HSG) with Lipiodol® is safe and has a therapeutic effect on fertility: transient in endometriosis-related infertility and sustained in unexplained infertility. Ultrasound is replacing fluoroscopy as the preferred imaging modality for HSG due to comfort and radiation safety (no ionising radiation). The safety of ultrasound-guided Lipiodol® HSG is uncertain.</p>\n </section>\n \n <section>\n \n <h3> Aims</h3>\n \n <p>Prospectively observe pregnancy and complication rates after ultrasound-guided Lipiodol® HSG.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>A single-centre prospective study of women with unexplained infertility undergoing ultrasound-guided Lipiodol® uterine bathing and tubal flushing after tubal patency confirmed with ExEm® Foam HyFoSy (hysterosalpingo-foam-sonography). Pregnancy outcomes at six months and serum and urinary thyroid function at one, three and eight weeks were recorded. Pain scores were recorded during and immediately after HSG. Descriptive statistics are reported.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Fifty-two participants were enrolled between July 2019 and April 2021, median age 33 years (range 21–45). Only 45 (87%, 45/52) completed the Lipiodol® HSG; 5/7 experienced intravasation during initial HyFoSy. Of 30 women at follow-up, 57% had biochemical (17/30, 95% CI 37%–75%), 53% clinical (16/30 95% CI 34%–72%) and 35% ongoing pregnancies (11/30, 95% CI 20%–56%). The rate of subclinical hypothyroidism (SCH) at two months was 41% (7/17). One intravasation event occurred during Lipiodol® HSG (2%, 1/45). Median pain score was 5/10 (range 0–9, interquartile range 2.5–7). No anaphylaxis, infection or oil embolism was observed.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Outpatient ultrasound-guided Lipiodol® HSG was safe, with pregnancy rates comparable to previous studies of fluoroscopic guidance. Rates of intravasation and SCH were also similar, confirming the need to monitor thyroid function.</p>\n </section>\n </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 4","pages":"326-333"},"PeriodicalIF":1.4000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13794","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian & New Zealand Journal of Obstetrics & Gynaecology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ajo.13794","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Fluoroscopic hysterosalpingography (HSG) with Lipiodol® is safe and has a therapeutic effect on fertility: transient in endometriosis-related infertility and sustained in unexplained infertility. Ultrasound is replacing fluoroscopy as the preferred imaging modality for HSG due to comfort and radiation safety (no ionising radiation). The safety of ultrasound-guided Lipiodol® HSG is uncertain.

Aims

Prospectively observe pregnancy and complication rates after ultrasound-guided Lipiodol® HSG.

Materials and Methods

A single-centre prospective study of women with unexplained infertility undergoing ultrasound-guided Lipiodol® uterine bathing and tubal flushing after tubal patency confirmed with ExEm® Foam HyFoSy (hysterosalpingo-foam-sonography). Pregnancy outcomes at six months and serum and urinary thyroid function at one, three and eight weeks were recorded. Pain scores were recorded during and immediately after HSG. Descriptive statistics are reported.

Results

Fifty-two participants were enrolled between July 2019 and April 2021, median age 33 years (range 21–45). Only 45 (87%, 45/52) completed the Lipiodol® HSG; 5/7 experienced intravasation during initial HyFoSy. Of 30 women at follow-up, 57% had biochemical (17/30, 95% CI 37%–75%), 53% clinical (16/30 95% CI 34%–72%) and 35% ongoing pregnancies (11/30, 95% CI 20%–56%). The rate of subclinical hypothyroidism (SCH) at two months was 41% (7/17). One intravasation event occurred during Lipiodol® HSG (2%, 1/45). Median pain score was 5/10 (range 0–9, interquartile range 2.5–7). No anaphylaxis, infection or oil embolism was observed.

Conclusion

Outpatient ultrasound-guided Lipiodol® HSG was safe, with pregnancy rates comparable to previous studies of fluoroscopic guidance. Rates of intravasation and SCH were also similar, confirming the need to monitor thyroid function.

Abstract Image

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
超声引导下 Lipiodol® 子宫输卵管造影术:关于妊娠和并发症发生率的前瞻性研究。
背景:使用 Lipiodol® 进行透视子宫输卵管造影(HSG)是安全的,对生育有治疗作用:对子宫内膜异位症相关不孕症有短暂疗效,对不明原因不孕症有持续疗效。由于舒适和辐射安全(无电离辐射),超声波正取代透视成为 HSG 的首选成像方式。目的:前瞻性观察超声引导下利必多®HSG术后的妊娠率和并发症发生率:单中心前瞻性研究:对不明原因不孕的妇女进行超声引导下 Lipiodol® 宫腔冲洗和输卵管冲洗,然后用 ExEm® 泡沫 HyFoSy(子宫输卵管造影)确认输卵管通畅。记录了六个月的妊娠结果以及一周、三周和八周的血清和尿甲状腺功能。记录了 HSG 期间和之后的疼痛评分。报告了描述性统计结果:52 名参与者于 2019 年 7 月至 2021 年 4 月间入组,中位年龄为 33 岁(21-45 岁不等)。只有 45 人(87%,45/52)完成了 Lipiodol® HSG;5/7 在最初的 HyFoSy 过程中出现了内侵。在随访的 30 名妇女中,57% 有生化指标(17/30,95% CI 37%-75%),53% 有临床指标(16/30 95% CI 34%-72%),35% 正在怀孕(11/30,95% CI 20%-56%)。两个月后出现亚临床甲状腺功能减退症(SCH)的比例为 41%(7/17)。在 Lipiodol® HSG 过程中发生了一起浸润事件(2%,1/45)。疼痛评分中位数为 5/10(范围 0-9,四分位间范围 2.5-7)。未观察到过敏性休克、感染或油栓塞:结论:门诊超声引导下的 Lipiodol® HSG 是安全的,妊娠率与之前的透视引导研究相当。浸润率和SCH的发生率也相似,这也证实了监测甲状腺功能的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
期刊最新文献
Long-term outcomes for women after dilator therapy with or without surgery in the creation of a neovagina. Management of detected syphilis in pregnancy adheres to guideline recommendations, but the crisis of congenital syphilis persists. An endometrial thickness of <12 mm does not exclude malignancy or pre-malignancy in cases of abnormal uterine bleeding: An observational study. Clinician compliance to intrapartum antibiotics prophylaxis for minimising neonatal group B streptococcal infection risk. 'Kind of scared but happy something was detected.' Cross-sectional survey of Let's Test for HPV participants to understand perspectives on an HPV detected result.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1