Hsg
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1. HSG, or hysterosalpingography, is a radiographic procedure used to evaluate the uterus and fallopian tubes. It requires proper technique and positioning of the uterus using a vulsellum for optimal evaluation of the uterine cavity. 2. Precautions should be taken during an HSG if intravasation is seen, such as slight withdrawal of the cannula and treatment for pelvic inflammatory disease if pain and vomiting occur post-procedure. 3. Cornual blockages seen on HSG may be due to spasm or plugging and can sometimes be treated with a flexible tip guidewire or Buscopan injection under expert guidance.
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Imaging in female infertility
imaging in female infertility radiological aspect. (hsg, usg, ct and mri)
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role of Imaging in female infertility
Imaging plays a key role in evaluating the causes of female infertility. Hysterosalpingography is often the initial exam to evaluate fallopian tube patency. Ultrasound can further characterize uterine abnormalities and detect ovarian issues. MRI is highly sensitive for detecting endometriosis. A systematic approach using one or more imaging modalities can help identify tubal, uterine, cervical or ovarian abnormalities causing infertility.
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Hysterosalpingography
Hysterosalpingography is a radiographic procedure used to evaluate the uterus and fallopian tubes. It involves inserting a cannula through the cervix and injecting radiopaque contrast material to visualize the uterine cavity and tubes. Normal findings include uniform filling of the uterine cavity and spillage of contrast into the peritoneal cavity. Abnormalities that can be detected include uterine anomalies, fibroids, adhesions, tubal blockages, spasms, and infections. The procedure provides important information for evaluating causes of infertility and recurrent pregnancy loss.
Ultrasound in infertility
This document provides information on Dr. Rupal N Shah, an experienced gynecologist and IVF consultant in Surat, India. It discusses her qualifications and experience in advanced infertility treatment, endoscopic surgeries, and her roles teaching and publishing on health topics. The rest of the document focuses on summarizing Dr. Shah's presentation on the uses of ultrasonography in infertility, including evaluating ovarian reserve, follicular development, polycystic ovary syndrome, ovarian cysts, uterine anomalies, and endometrial thickness.
SONOSALPINGOGRAPHY STEPS BY LATE DR SAKSHI
HOPE THIS WILL HELP ALL
PRESENTATION MADE BY YOUNG SAKSHI OUR FAVORITE IMAGING SPECIALIST WHO WE LOST DUE TO CANCER
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Ultrasound and occasionally MRI are used to image the scrotum and testes. Ultrasound can distinguish between intra-testicular and extra-testicular causes of swelling or pain such as tumors, varicocele, hydrocele, and infections. Doppler ultrasound can determine if reduced blood flow in a testicle is caused by torsion or normal flow from epididymitis. Ectopic testes in the inguinal canal can also be diagnosed by ultrasound.
Hysterosalpingography
This document provides information on hysterosalpingography (HSG) procedures, including equipment used, indications, contraindications, timing, normal findings, and various abnormal findings. It lists conditions that can be evaluated with HSG such as infertility, congenital uterine anomalies, recurrent miscarriage, abnormal bleeding, and uterine masses. Potential risks including pain, bleeding, infection, and allergic reaction are noted. Images demonstrate normal uterine anatomy and various uterine anomalies detectable on HSG.
Recommended
Imaging in female infertility
imaging in female infertility radiological aspect. (hsg, usg, ct and mri)
dr deepak resident radiodiagnosis, gmc patiala
role of Imaging in female infertility
Imaging plays a key role in evaluating the causes of female infertility. Hysterosalpingography is often the initial exam to evaluate fallopian tube patency. Ultrasound can further characterize uterine abnormalities and detect ovarian issues. MRI is highly sensitive for detecting endometriosis. A systematic approach using one or more imaging modalities can help identify tubal, uterine, cervical or ovarian abnormalities causing infertility.
Sonosalpingography. Dr. Sharda Jain, Dr. Jyoti Agarwal
Evaluation of fallopian tubes forms an essential part of evaluation
Tubal pathology is a cause of infertility in 30- 35% of infertile patients
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Fallopian tubes can be assessed by:
Hysterosalpingography
Hysterosalpingo-contrast-sonography (HycoSy)
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Hysterosalpingography
Hysterosalpingography is a radiographic procedure used to evaluate the uterus and fallopian tubes. It involves inserting a cannula through the cervix and injecting radiopaque contrast material to visualize the uterine cavity and tubes. Normal findings include uniform filling of the uterine cavity and spillage of contrast into the peritoneal cavity. Abnormalities that can be detected include uterine anomalies, fibroids, adhesions, tubal blockages, spasms, and infections. The procedure provides important information for evaluating causes of infertility and recurrent pregnancy loss.
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SONOSALPINGOGRAPHY STEPS BY LATE DR SAKSHI
HOPE THIS WILL HELP ALL
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Radiology 5th year, 7th lecture (Dr. Nasrin Alatrushi)
Ultrasound and occasionally MRI are used to image the scrotum and testes. Ultrasound can distinguish between intra-testicular and extra-testicular causes of swelling or pain such as tumors, varicocele, hydrocele, and infections. Doppler ultrasound can determine if reduced blood flow in a testicle is caused by torsion or normal flow from epididymitis. Ectopic testes in the inguinal canal can also be diagnosed by ultrasound.
Hysterosalpingography
This document provides information on hysterosalpingography (HSG) procedures, including equipment used, indications, contraindications, timing, normal findings, and various abnormal findings. It lists conditions that can be evaluated with HSG such as infertility, congenital uterine anomalies, recurrent miscarriage, abnormal bleeding, and uterine masses. Potential risks including pain, bleeding, infection, and allergic reaction are noted. Images demonstrate normal uterine anatomy and various uterine anomalies detectable on HSG.
H.s.g
This document provides an overview of hysterosalpingography (HSG), a radiographic procedure used to examine the uterus and fallopian tubes. It begins with a brief anatomical review of the female reproductive system. It then describes the HSG procedure, including how contrast media is injected to visualize the uterus and fallopian tubes via x-ray. The document outlines the indications for HSG, including evaluating infertility and detecting blockages. It provides details on patient preparation, necessary equipment, positioning during the procedure, and presents an example image showing contrast filling the uterine cavity and fallopian tubes.
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- The document describes the equipment, procedure, and findings of a hysterosalpingogram (HSG). An HSG uses fluoroscopy and radiopaque contrast to visualize the uterine cavity and fallopian tubes.
- The procedure involves inserting a catheter into the cervix and injecting contrast while taking x-ray images. Abnormal findings may indicate conditions like uterine anomalies, fibroids, adhesions, or tubal blockages.
- Complications are generally minor but can include pain, spotting, or rarely infection or contrast reaction. The HSG provides important information to evaluate infertility or other gynecological conditions.
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includes imaging modalities and asssociated findings in different pathologies of male and female factor of infertility
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2. Ultrasound is first-line for diagnosis and may show an echogenic endometrial mass with low-resistance, high-velocity blood flow. Thickened endometrium (>10mm) or intrauterine fluid also suggest RPOC.
3. Differential diagnosis includes uterine atony, blood clots, or arteriovenous malformation. Presentation involves delayed bleeding or endometritis. Expectant management is appropriate for minimal vascularity; medication or surgery is
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1. The document provides guidance on using ultrasound to evaluate common emergency obstetric conditions, including vaginal bleeding and pelvic pain in the first, second, and third trimesters.
2. Key first trimester ultrasound findings discussed include yolk sac presence/size and cardiac activity for evaluating failed pregnancies. Common causes of first trimester bleeding like ectopic pregnancy, miscarriage, and molar pregnancy are reviewed.
3. Second and third trimester bleeding conditions like placenta previa, placenta accreta, placental abruption, and vasa previa are covered, along with their ultrasound identification and management.
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1. The document discusses various methods for evaluating tubal patency in infertile patients, including hysterosalpingography (HSG), laparoscopy, and tests like Chlamydia antibody testing.
2. HSG is the most common screening test but has limitations like radiation exposure and false positives. Findings on HSG like mucosal rugae can provide prognostic information.
3. Laparoscopy allows direct visualization but is more invasive. It remains the gold standard for diagnosing conditions like endometriosis.
4. For treatment, IVF is now often preferred over surgery for moderate to severe tubal damage, while laparoscopic surgery may be considered for milder issues
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This document discusses several congenital genital defects including cryptorchidism, hypospadias, chordee, micropenis, and others. It provides details on the embryological development of the genitals. For hypospadias, it describes the condition as an abnormal urethral opening on the ventral penis and notes increasing rates. Surgical correction aims to widen the meatus, correct curvature, and reconstruct the urethra. Techniques discussed include TIP urethroplasty and flap procedures. Complications can include fistula, stenosis, and stricture.
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this presentation evaluates all the methods for evaluation of fallopian tubes
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1. It describes procedures like dilation and curettage (D&C), endometrial ablation, and cervical cerclage - outlining their indications, techniques, and potential complications.
2. Endometrial ablation is presented as a minimally invasive option for abnormal uterine bleeding that does not require hysterectomy. Non-hysteroscopic methods like balloon and thermal ablation are discussed.
3. Cervical cerclage is explained as a surgical technique used to prevent cervical insufficiency and recurrent mid-trimester pregnancy loss, with prophylactic cerclage placed electively at 14 weeks
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This document contains descriptions and radiographic images of various uterine and fallopian tube abnormalities that can be identified on hysterosalpingograms. These include normal anatomy as well as pathologies such as polyps, fibroids, adhesions, deformities, occlusions, and hydrosalpinges. Spot radiographs are shown demonstrating the characteristic appearances of these different conditions within the uterus and fallopian tubes.
Hypospadiasis,descended testis
This document discusses two congenital conditions: hypospadias and undescended testis. It defines hypospadias as a birth defect where the urethra opening is located on the underside of the penis rather than at the tip. It classifies the different types of hypospadias based on the location of the urethra opening. Surgery is usually done before age 18 months to correct the condition. Undescended testis occurs when one or both testicles fail to descend into the scrotum. Early surgery before age 1 can help address risks like infertility and cancer. Both conditions require monitoring after any surgical repairs.
Hsg ppt
The document describes a hysterosalpingography procedure used to evaluate the uterine cavity and fallopian tubes. Key points include: HSG involves injecting radiopaque contrast medium under fluoroscopy to visualize the uterus and tubes. It is commonly used to investigate infertility. The procedure involves catheterizing the cervix and injecting contrast. Findings are interpreted to evaluate for abnormalities like tubal blockages. Common findings and their differential diagnoses are discussed. Risks are generally minor but can include infection, reaction to contrast, or radiation exposure.
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A RARE CASE PRESENTATION OF OVARIAN ECTOPIC PREGNANCY
This presentation describes a rare care of ruptured ovarian ectopic pregnancy with chronic appendicitis
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For further notes, you can join us on our Telegram group @obgynsphmmc2019
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H.s.g
This document provides an overview of hysterosalpingography (HSG), a radiographic procedure used to examine the uterus and fallopian tubes. It begins with a brief anatomical review of the female reproductive system. It then describes the HSG procedure, including how contrast media is injected to visualize the uterus and fallopian tubes via x-ray. The document outlines the indications for HSG, including evaluating infertility and detecting blockages. It provides details on patient preparation, necessary equipment, positioning during the procedure, and presents an example image showing contrast filling the uterine cavity and fallopian tubes.
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Adherent placenta occurs when there is a defect in the decidua basalis, Resulting in an abnormal invasion of the placenta directly into the substance of the uterus
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This document discusses the management of the third stage of labor. It describes signs that the placenta is separating, including the uterus becoming more mobile. It recommends controlled cord traction using the Brandt-Andrews technique to deliver the placenta within 20 minutes to reduce blood loss. If the placenta is not delivered by this method, manual removal may be necessary, especially if there is morbid adherence of the placenta. An injection of syntometrine after delivery can also help reduce postpartum hemorrhage risk. The fundus and blood loss should be monitored after delivery to ensure no placenta fragments are retained.
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Anorectal malformations (ARMs) are birth defects affecting the development of the rectum and anus. They occur due to abnormal development during fetal growth. ARMs can range from mild defects like fistulas to more severe defects like cloaca. Diagnostic tests like X-rays and ultrasound are used to classify the defect and identify associated issues. Surgical intervention is needed to correct the defect, often using staged procedures like colostomy followed later by posterior sagittal anorectoplasty. Nursing care focuses on pre-and post-operative stabilization, wound care, and supporting bowel function and continence development.
Mayer rokitansky-küster-hauser syndrome
An 18-year-old woman presented with primary amenorrhea and dyspareunia. MRI showed a complete absence of the cervix and uterus with an abnormally truncated vagina, along with normal ovaries and unilateral renal agenesis. This is consistent with Mayer-Rokitansky-Küster-Hauser syndrome, a condition caused by disruption of müllerian duct development during embryogenesis that results in müllerian duct anomalies. Imaging plays an essential role in diagnosing müllerian duct anomalies and determining appropriate treatment.
Hysterosalpingography
- The document describes the equipment, procedure, and findings of a hysterosalpingogram (HSG). An HSG uses fluoroscopy and radiopaque contrast to visualize the uterine cavity and fallopian tubes.
- The procedure involves inserting a catheter into the cervix and injecting contrast while taking x-ray images. Abnormal findings may indicate conditions like uterine anomalies, fibroids, adhesions, or tubal blockages.
- Complications are generally minor but can include pain, spotting, or rarely infection or contrast reaction. The HSG provides important information to evaluate infertility or other gynecological conditions.
Imaging in infertility
includes imaging modalities and asssociated findings in different pathologies of male and female factor of infertility
Retained products of conception dr.mohamed Soliman
1. Retained products of conception (RPOC) refers to incomplete evacuation of placental or trophoblastic tissue in the endometrial cavity after abortion, delivery, or cesarean section.
2. Ultrasound is first-line for diagnosis and may show an echogenic endometrial mass with low-resistance, high-velocity blood flow. Thickened endometrium (>10mm) or intrauterine fluid also suggest RPOC.
3. Differential diagnosis includes uterine atony, blood clots, or arteriovenous malformation. Presentation involves delayed bleeding or endometritis. Expectant management is appropriate for minimal vascularity; medication or surgery is
Ultrasound in Obstetric Emergencies by Dr Wannanee Meennuch
1. The document provides guidance on using ultrasound to evaluate common emergency obstetric conditions, including vaginal bleeding and pelvic pain in the first, second, and third trimesters.
2. Key first trimester ultrasound findings discussed include yolk sac presence/size and cardiac activity for evaluating failed pregnancies. Common causes of first trimester bleeding like ectopic pregnancy, miscarriage, and molar pregnancy are reviewed.
3. Second and third trimester bleeding conditions like placenta previa, placenta accreta, placental abruption, and vasa previa are covered, along with their ultrasound identification and management.
Tubal factor infertility
1. The document discusses various methods for evaluating tubal patency in infertile patients, including hysterosalpingography (HSG), laparoscopy, and tests like Chlamydia antibody testing.
2. HSG is the most common screening test but has limitations like radiation exposure and false positives. Findings on HSG like mucosal rugae can provide prognostic information.
3. Laparoscopy allows direct visualization but is more invasive. It remains the gold standard for diagnosing conditions like endometriosis.
4. For treatment, IVF is now often preferred over surgery for moderate to severe tubal damage, while laparoscopic surgery may be considered for milder issues
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This document discusses several congenital genital defects including cryptorchidism, hypospadias, chordee, micropenis, and others. It provides details on the embryological development of the genitals. For hypospadias, it describes the condition as an abnormal urethral opening on the ventral penis and notes increasing rates. Surgical correction aims to widen the meatus, correct curvature, and reconstruct the urethra. Techniques discussed include TIP urethroplasty and flap procedures. Complications can include fistula, stenosis, and stricture.
Imaging in tubal factors in infertility.
tubal factor is almost 30% of all female infertility causes.Hence evaluation of tubes is usulally the first of the testings.
this presentation evaluates all the methods for evaluation of fallopian tubes
Lecture by PROF.DR. AISHA ELBAREG {common gynecologic surgical-procedures}.
This document provides an overview of common gynecological surgical procedures and includes the following key points:
1. It describes procedures like dilation and curettage (D&C), endometrial ablation, and cervical cerclage - outlining their indications, techniques, and potential complications.
2. Endometrial ablation is presented as a minimally invasive option for abnormal uterine bleeding that does not require hysterectomy. Non-hysteroscopic methods like balloon and thermal ablation are discussed.
3. Cervical cerclage is explained as a surgical technique used to prevent cervical insufficiency and recurrent mid-trimester pregnancy loss, with prophylactic cerclage placed electively at 14 weeks
Vaginal Hysterectomy
Vaginal hysterectomy is a procedure to remove the uterus through the vagina. It has advantages over abdominal hysterectomy like earlier recovery, less pain, and lower morbidity. The key steps involve exposing and clamping the uterine vessels and ligaments, then removing the uterus. The vaginal cuff and pelvic floor are repaired with sutures to prevent prolapse. Post-operative care involves bladder drainage, antibiotics, pain relief, and monitoring for potential complications like bleeding or infection.
Anorectal malformations in children
Anorectal malformations are congenital defects that occur during gestation when the rectum fails to descend and connect to the anal opening. They range from mild defects like anal stenosis to more severe ones like rectal atresia. Treatment involves surgical correction like colostomy followed by anoplasty. Nursing care focuses on wound, stoma and postoperative bowel care to support healing and prevent complications.
Hysterosalpingography cases
This document contains descriptions and radiographic images of various uterine and fallopian tube abnormalities that can be identified on hysterosalpingograms. These include normal anatomy as well as pathologies such as polyps, fibroids, adhesions, deformities, occlusions, and hydrosalpinges. Spot radiographs are shown demonstrating the characteristic appearances of these different conditions within the uterus and fallopian tubes.
Hypospadiasis,descended testis
This document discusses two congenital conditions: hypospadias and undescended testis. It defines hypospadias as a birth defect where the urethra opening is located on the underside of the penis rather than at the tip. It classifies the different types of hypospadias based on the location of the urethra opening. Surgery is usually done before age 18 months to correct the condition. Undescended testis occurs when one or both testicles fail to descend into the scrotum. Early surgery before age 1 can help address risks like infertility and cancer. Both conditions require monitoring after any surgical repairs.
Hsg ppt
The document describes a hysterosalpingography procedure used to evaluate the uterine cavity and fallopian tubes. Key points include: HSG involves injecting radiopaque contrast medium under fluoroscopy to visualize the uterus and tubes. It is commonly used to investigate infertility. The procedure involves catheterizing the cervix and injecting contrast. Findings are interpreted to evaluate for abnormalities like tubal blockages. Common findings and their differential diagnoses are discussed. Risks are generally minor but can include infection, reaction to contrast, or radiation exposure.
Undescended testis
Gaurav Nahar discusses undescended testis (cryptorchidism). Cryptorchidism occurs when one or both testes fail to descend into the scrotum. It has a prevalence of 1-4% in full term males and 1-45% in preterm males. Testicular descent is a complex process involving hormonal and mechanical factors. Cryptorchidism can be congenital, acquired, or syndromic. Evaluation involves history, exam to locate any undescended testes, and sometimes imaging or labs. Treatment is usually surgical orchidopexy to position testes in scrotum.
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This document discusses the evaluation and management of acute abdomen during pregnancy. It outlines common etiologies including appendicitis, bowel obstruction, and pregnancy-related causes. The evaluation involves history, physical exam focusing on signs of peritonitis, and lab tests. Imaging options like ultrasound and MRI are discussed. Laparoscopy is generally safe in pregnancy with precautions. Acute appendicitis is the most common non-obstetric surgical emergency. It can be more severe in pregnancy and risks increase with delayed treatment.
Hemorrhage in late pregnancy
This document provides an overview of antepartum hemorrhage, with a focus on placenta previa. It defines antepartum hemorrhage and the two main causes - placenta previa and abruptio placentae. It discusses the definition, incidence, etiology, pathological anatomy, types, clinical features, diagnosis, complications, prognosis, prevention, and management of placenta previa. Key points include that placenta previa occurs when the placenta implants in the lower uterine segment, the risk increases with prior c-sections, diagnosis is made through ultrasound, and management involves expectant treatment or cesarean delivery depending on gestational age and severity of bleeding.
spon abortion.ppt
Spontaneous abortion, also known as miscarriage, is the clinically recognized loss of a pregnancy before 20 weeks gestation. It is the most common complication of early pregnancy, with a frequency that decreases with increasing gestational age. Risk factors include advanced maternal age, previous spontaneous abortion, smoking, certain medications, extremes of maternal weight, and maternal infections. Spontaneous abortions are usually due to fetal abnormalities but can also result from maternal factors. Presenting symptoms include vaginal bleeding and pelvic pain. Diagnosis involves pelvic examination, ultrasound criteria, and serial beta hCG levels. Management depends on the classification of abortion as threatened, incomplete, or missed and may involve expectant monitoring, medical treatment, or surgical evacuation
Practical tips for monitoring of an iui cycle
Ultrasound monitoring is the accepted method for monitoring infertility treatment cycles. It allows evaluation of follicle growth, endometrial development, and risk of ovarian hyperstimulation. Transvaginal ultrasound is recommended starting on day 6-8 of stimulation to measure follicle size and number. The leading follicle is typically 18-20mm at the time of hCG trigger. Endometrial thickness should be 7-14mm on the day of trigger. Doppler ultrasound can assess blood flow and predict ovarian response and uterine receptivity. With experienced use of ultrasound alone, additional hormonal monitoring is often unnecessary for cycle monitoring in infertility treatment.
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Hsg
- 1. HSG Department of reproductive medicine Bansal hospital Dr Pallavi Agrawal / Dr Jayant Yadav
- 2. case 1 • 24 years female married for 3 years - HSG – reported as small uterus - advised against pregnancy
- 6. • HSG – has a role in uterine cavity evaluation • Improper centralization of uterus will not allow us cavity evaluation • So proper traction is required with vulsellum
- 7. Case – 2 • 26 years female k/c/o PCOS • Has been given 3 cycles of ovulation induction • HSG – reported as B/L free spill • Further planned for 3 cycles of OI
- 10. • Prevalence – 0.4- 6.9% • Level – 0 - no - 1- up to myometrium - 2 – parametrial vessel - 3 – pelvic vessels • Fat embolism In oil based contrast • More common during preovulatory phase
- 11. case – 3 • Para 3001 with secondary infertility of 2 years • Previous 3 vaginal delivery • HSG – B/L fimbrial block
- 15. • Proper size of leech Wilkinson cannula • Keep extra dye in hand
- 16. Case 4 • 26 years married for 1 year • After HSG having pain and vomiting • HSG – B/L cornual block • Treated for PID what precautionary measures should be taken here
- 19. Slightly withdrawal of cannula should be done - if intravasation is seen along with pain
- 20. Case 5 • HSG – reported as B/L cornual block • Someone suggested repeat HSG after few days • Do you agree with repeat HSG idea or something else
- 24. • Upto 2/3rd of cornual blocks are either due to spasm or plugging • Flexible tip guidewire is an option in experts hand • Buscopan injection • Rotation of patient to 45 degree
- 25. Case - 6 • HSG – showing filling defect • What are the differential diagnosis
- 31. • Air bubble – moves • Synechiae – irregular edges • Polyp – regular edges • Submucosal fibroid Clinical history of patient along with sonographic details can help in correct interpretation
- 32. Case - 7 - P0010 – HSG reported as bicornuate uterus - advised for fertile period
- 35. • Septate uterus is more common anomaly than bicornuate uterus • HSG has accuracy of 75% • 3 D sonography has accuracy of 98%
- 36. Case - 8 • 30 years female with BMI 21 • Complains of decreased blood flow during periods • HSG – B/L distal tubal block • Please comment upon HSG films
- 40. • Right tubal involvement more than left • Cornual block is uncommon • Midtubal block is more common • Loculated spill is also seen
- 41. Case 9 • Para 0100 – underwent HSG • Reported as normal
- 43. • There is little evidence of importance of dilated internal os in HSG and pregnancy outcome • History in these cases is helpful
- 44. Case 10 • P0010 – has history of menorrhagia • HSG – attached
- 48. • Whenever one cavity is shown only we have to look for another • Incidence of unicornuate uterus is 0.3%
- 49. CASE-11 • 23 years lean PCOS patient was given clomiphene citrate 150 mg • HSG was planned on day 10 of period
- 52. 13 - • What is the choice of pain relief for HSG
- 53. Case - 14 • 30 years P0030 underwent USG • s/o – right ovarian cyst • HSG – was ordered after 3 months of OCS
- 56. Case -15 • P1001 with prolonged heavy bleeding during periods
- 59. Case 16 • Again pain during HSG , but post procedure pain decreased significantly