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Radiology in Gynaecology, Indications and contraindications

1. Hysterosalpingography

Operative procedure used to assess the interior anatomy of the uterus and tube including tubal patency.
It is Radiographic study and a contrast media is used.

Indications –

  • Detection of Uterine malformations
  • Detection of translocated IUDs
  • Diagnosis of cervical incompetence
  • Assessment of tubal patency in investigation of infertility.
  • Incidental diagnosis of Submucous fibroid or an Uterine polyp.

Contraindications –

▪️Pelvic infection
▪️Women known to have hydrosalpinge ▪️Pelvic tenderness
▪️Presence of adrenal mass

2. USG- Ultrasonography

Non invasive imaging procedure that utilizes high frequency sound Waves.
Used widely in Gynaecology either with
Transabdomenal (TAS) or transvaginal (TVS)

Uses-

◾Infertility workup.
◾Serial measurement of ovarian follicular and endometrial thickness are done using TVS.
◾ USG provide presumptive evidence of ovulation.
◾ To detect correct timing of ovulation.
◾Endometrial disease
◾To locate missing IUD
◾Sonographically guided pro

3. Hysteroscopy

Procedure that allows direct visualization inside the Uterus.
It can be used for diagnostic as well as
therapeutic purpose.

Basic instruments and electrosurgical units-

  • Telescope
  • Distending media
  • Flexible telescopes
  • Microhysteroscope
  • Telescope sheath

Liquid media- Glycine 1.5% Mannitol + Glycine

Accessory Instruments- forceps, scissors grasping forceps, Image recorder, Camera, light source

Indications-

🔻Diagnostic-
◾Abnormal uterine bleeding.
◾Infertility – when associated with hysterosalpingogram
◾Recurrent Miscarriage
◾ Misplaced IUD.
🔻 Operative
◾polypectomy and myomectomy
◾Endometrial ablation
◾endometrial resection
◾Biopsy. ◾Removal of foreign body/ IUD.
◾Sterilisation

Contraindications-

◾Pelvic Infection
◾Pregnancy
◾Cervical cancer
◾Cardiopulmonary disorder
◾Cervical stenosis

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