Which of the following is exact period for HSG (hysteronsalpingography)?
Ans. c (Between end of menstruation and ovulation) (Ref. Grainger & Allison's Diagnostic Radiology, 5th ed., Ch. 54)HYSTEROSALPINGOGRAPHY (HSG)# Hysterosalpingography (HSG) plays an important role in the evaluation of abnormalities related to the uterus and fallopian tubes.# Uterine abnormalities that can be detected at HSG include -- Congenital anomalies,- Polyps,- Leiomyomas,- Surgical changes,- Synechiae, and- Adenomyosis.# Tubal abnormalities that can be detected include -- Tubal occlusion,- Salpingitis isthmica nodosum,- Polyps,- Hydrosalpinx, and- Peritubal adhesions.# HSG remains a valuable tool in the evaluation of the uterus and fallopian tubes.Indications for HSG# Infertility# Recurrent spontaneous abortions# Postoperative evaluation following tubal ligation or reversal of tubal ligation# Preoperative evaluation prior to myomectomyContraindications for HSG# Pregnancy# Active pelvic infection.Timing of study# The examination should be scheduled during days 7-12 of the menstrual cycle (day 1 being the first day of menstrual bleeding).# The endometrium is thin during this proliferative phase, a fact that facilitates image interpretation and should also ensure that there is no pregnancy.Educational Points:Comparison of hysterosalpingography with laparoscopy:HysterosalpingographyLaparoscopy and dye hydrotubationOutpatient procedureDay surgery procedureAnalgesia adequateGeneral anesthesia requiredSimple, inexpensiveExpensiveGives uterine cavity informationShows outer contour of the uterus only (unless with hysteroscopy)Tubal patency testedShows appearance of tubes and their patency; also of ovaries and pelvic peritoneumScreening testDefinitive testNot particularly sensitive for - mild distal tubal disease or endometriosisDistal tubal disease or endometriosis can be diagnosed and treated.# HSG is the best method for visualizing and evaluating the fallopian tubes.
Just before Menstruation
During Menstruation
Between end of menstruation and ovulation
On 28th day of menstrual cycle
Obstetrics And Gynaecology