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Technology assessment of saline contrast hysterosonography

      Abstract

      Objective: The purpose of our study was to evaluate to which extent saline contrast hysterosonography (SCHS) is able to replace diagnostic hysteroscopy in uterine cavity evaluation in women suspected of intrauterine abnormalities. Study Design: In this prospective observational study we performed SCHS instead of diagnostic hysteroscopy. Diagnostic hysteroscopy was performed in case of failed or inconclusive SCHS. Univariate and multivariate analyses were used to assess subgroups for their risk of failure and inconclusiveness. Results: Two hundred fourteen women were included consecutively. SCHS was conclusive in 180 cases (84.1%), failed in 12 (5.6%), and inconclusive in 22 (10.3%). Uterine size above 600 cm3 was the best predictor of failure and/or inconclusiveness (positive predictive value 0.42). Conclusion: SCHS was able to replace 84% of the outpatient diagnostic hysteroscopies in uterine cavity evaluation in women suspected of intrauterine abnormalities. Our study showed that diagnostic hysteroscopy can be restricted to inconclusive or failed SCHS. (Am J Obstet Gynecol 2003;188:945-9.)

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      References

        • Gimpelson RJ
        • Rappold HO
        A comparative study between panoramic hysteroscopy with directed biopsies and dilatation and curettage.
        Am J Obstet Gynecol. 1988; 158: 489
        • Mihm LM
        • Quick VA
        • Brumfield JA
        • Connors AF
        • Finnerty JJ
        The accuracy of endometrial biopsy and saline sonohysterography in the determination of the cause of abnormal uterine bleeding.
        Am J Obstet Gynecol. 2002; 186: 858-860
        • Cicinelli E
        • Romano F
        • Anastasio PS
        • Blasi N
        • Parisi C
        Sonohysterography versus hysteroscopy in the diagnosis of endouterine polyps.
        Gynecol Invest. 1994; 38: 266-271
        • Campo R
        • Van Belle Y
        • Rombauts L
        • Brosens I
        • Gordts S
        Office mini-hysteroscopy.
        Hum Reprod Update. 1999; 5: 73-81
        • Widrich T
        • Bradley LD
        • Mitchinson AR
        • Collins RL
        Comparison of saline infusion sonography with office hysteroscopy for the evaluation of the endometrium.
        Am J Obstet Gynecol. 1996; 174: 1327-1334
        • Dueholm M
        • Jensen ML
        • Laursen H
        • Kracht P
        Can the endometrial thickness as measured by trans-vaginal sonography be used to exclude polyps or hyperplasia in pre-menopausal patients with abnormal uterine bleeding?.
        Acta Obstet Gynecol Scand. 2001; 80: 645-651
        • Jones K
        • Bourne TH
        The feasibility of a “one stop” ultrasound-based clinic for the diagnosis and management of abnormal uterine bleeding.
        Ultrasound Obstet Gynecol. 2001; 17: 517-521
        • Schwarzler P
        • Concin H
        • Bosch H
        • Berlinger A
        • Wohlgenannt K
        • Collins WP
        • et al.
        An evaluation of sonohysterography and diagnostic hysteroscopy for the assessment of intrauterine pathology.
        Ultrasound Obstet Gynecol. 1998; 11: 337-342
        • de Vries LD
        • Dijkhuizen FP
        • Mol BW
        • Brölmann HA
        • Moret E
        • Heintz AP
        Comparison of transvaginal sonography, saline infused sonography and hysteroscopy in the work-up of premenstrual women with abnormal uterine bleeding.
        J Clin Ultrasound. 2000; 28: 217-223
        • Karlsson B
        • Granberg S
        • Wikland M
        • Ylostalo P
        • Torvid K
        • Marsal K
        • et al.
        Transvaginal ultrasonography of the endometrium in women with postmenopausal bleeding: a Nordic multicenter study.
        Am J Obstet Gynecol. 1995; 172: 1488-1494
        • Dijkhuizen FP
        • de Vries LD
        • Mol BW
        • Brolmann HA
        • Peters HM
        • Moret E
        • et al.
        Comparison of transvaginal sonography and saline infusion sonography for the detection of intracavitary abnormalities in premenopausal women.
        Obstet Gynecol. 2000; 15: 1-6
        • Williams CD
        • Marshburn PB
        A prospective study of transvaginal hydrosonography in the evaluation of abnormal bleeding.
        Am J Obstet Gynecol. 1998; 179: 292-298
        • Krampl E
        • Bourne T
        • Hurlen-Solbakken H
        • Istre O
        Transvaginal ultrasonography sonohysterography and operative hysteroscopy for the evaluation of abnormal uterine bleeding.
        Acta Obstet Gynecol Scand. 2001; 80: 616-622
        • Timmerman D
        • Deprest J
        • Bourne T
        • Van den Berghe I
        • Collins WP
        • Vergote I
        A randomized trial on the use of ultrasonography or office hysteroscopy for endometrial assessment in postmenopausal patients with breast cancer who were treated with tamoxifen.
        Am J Obstet Gynecol. 1998; 179: 62-70
        • Dijkhuizen FP
        • Mol BW
        • Bongers MY
        • Brolmann HA
        • Heintz AP
        Cost-effectiveness of the use of transvaginal sonography and saline infusion sonography in the evaluation of menorrhagia [thesis].
        in: University of Utrecht, Utrecht (The Netherlands):2000: 114-115
        • Carlos RC
        • Bree RL
        • Abrahamse PH
        • Fendrick AM
        Cost-effectiveness of saline-assisted hysterosonography and office hysteroscopy in the evaluation of postmenopausal bleeding: a decision analysis.
        Acad Radiol. 2001; 8: 835-844
        • Parsons AK
        • Lense JJ
        Sonohysterography for endometrial abnormalities: preliminary results.
        J Clin Ultrasound. 1993; 21: 87-95
        • Wamsteker K
        • de Blok S
        Diagnostic hysteroscopy: technique and documentation.
        in: Endoscopic surgery for gynecologists. WB Saunders, London1993: 263-276
        • Goldstein SR
        • Zeltser I
        • Horan CK
        • Snyder JR
        • Schwartz LB
        Ultrasonography-based triage for perimenopausal patients with abnormal bleeding.
        Am J Obstet Gynecol. 1997; 177: 102-108
        • Gaucherand P
        • Piacenza JM
        • Salle B
        • Rudigoz RC
        Sonohysterography of the uterine cavity: preliminary investigations.
        J Clin Ultrasound. 1995; 23: 339
        • Epstein E
        • Ramirez A
        • Skoog L
        • Valentin L
        Transvaginal sonography, saline contrast sonohysterography and hysteroscopy for the investigation of women with postmenopausal bleeding and endometrium > 5mm.
        Ultrasound Obstet Gynecol. 2001; 18: 157-162
        • Dessole S
        • Farina M
        • Capobianco G
        • Nardelli GB
        • Ambrosini G
        • Meloni GB
        Determining the best catheter for sonohysterography.
        Fertil Steril. 2001; 76: 605-609
        • Dueholm M
        • Forman A
        • Jensen ML
        • Laursen H
        • Kracht P
        Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding.
        Ultrasound Obstet Gynecol. 2001; 18: 54-61
        • Cicinelli E
        • Romano F
        • Anastasio PS
        • Blasi N
        • Parisi C
        • Galantino P
        Transabdominal sonohysterography, transvaginal sonography and hysteroscopy in the evaluation of submucous myomas.
        Obstet Gynecol. 1995; 85: 42-47