Radiology

It combines of two Categories:

Hysterosalpingography

Definition:

  • Imaging of the uterus and the fallopian tubes with the help of X-ray after instilling radio opaque contrast in the uterus. Commonly called coloured X-ray of the uterus.

Uses:

  • Hysterosalpingography (HSG) though apparently a simple technique, can provide valuable insight into the uterine and tubal factors of infertility. Precision and following correct technique help in providing good quality HSG films.

Procedures:

  • HSG is performed between menstrual cycle days 6 and 11. It should not be done near ovulation or in the presence of pelvic infection. The procedure is best performed using fluoroscopy or image intensifier. A pain killer given half an hour prior to the procedure minimizes cramping and discomfort. The dye is injected in the uterus and tubes under image guidance and X-ray plates are taken.

Advantages:

  • Simple.
  • Costs about 2200-2500 rupees.
  • Gives good information.
  • Increases expertise and good equipment.
  • Increases chances of pregnancy

Disadvantages:

  • Needs expertise and good equipment.
  • Inconclusive reports are quite common.
  • Painful.
  • May need laparoscopy to confirm findings

 

Ultrasound

What it means?

  • Ultrasound is a diagnostic modality with the help which we can see inside the abdomen, pelvis, uterus and baby. All the structures can be seen and directly assessed instead of just blindly feeling and guessing. In gynaecology and obstetrics transvaginal ultrasound is the most reliable and preferred method.

Who are suitable candidates?

  • Ultrasound has become an essential part of modern day gynaecology and obstetrics. It is almost unthinkable to make diagnosis without ultrasound.
  • All normal and abnormal pregnancies
  • All gynae problems
  • Normal gynae check up
  • Infertility and IVF management
  • Any guided procedures e.g. IVF, amniocentesis, etc.

Who should not get ultrasound?

    • There is practically no known complication or contraindication of ultrasound. Limited information may be available in some obese or difficult situations. Additional tests like MRI etc. may be required.

What are its main procedures?

      • Trans abdominal and transvaginal procedures

Advantages:

      • Highly accurate diagnosis
      • Very safe even for babies in uterus
      • Can be repeated easily
      • Relatively cost effective
      • Infertility management and IVF are dependent on ultrasound

Disadvantages:

      • Cost

Legal issues:

    • Ultrasound is covered under PCPNDT act which requires consent, record keeping. All ultrasound centres and obstetric scans are closely monitored by appropriate authority