Evaluation of Indications of Saline Infusion Sonohysterography in a Private Hospital in Nigeria: A Retrospective Study QC11-QC14
Dr. Ikechukwu Innocent Mbachu,
Lecturer, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi Campus,
PMB-5025, Nnewi, Anambra, Nigeria.
Introduction: Despite the obvious advantages of Saline Infusion Sonohysterography (SIS) in the evaluation of infertile couples, its uptake is still poor in developing countries.
Aim: To evaluate the indications and findings of SIS and also to compare the findings in the fallopian tubes of women who had Hysterosalpingography (HSG) before SIS.
Materials and Methods: This was a retrospective study of consecutive SIS done in 27 women with infertility and 1 woman with abnormal uterine bleeding at The Light Specialist Hospital Nnewi, Anambra, Nigeria (November 2012 to May 2017). The ultrasound registers were used to identify women who had SIS. Relevant information was extracted from their folders and ultrasound records. These included sociodemographic characteristics, parity, and indication for the procedure, previous HSG findings and findings from the SIS. Data obtained were entered into SPSS version 24.0 and analysed.
Results: The mean age of the women was 33.6±7 years with 13 (46.4%) out of 28 being greater or equal to 35 years. The mean duration of infertility was 3.4 years. A total of 28 women had SIS during the study period and the procedure could not be completed in one of the patients. Twenty one of the patients had done a HSG before presentation with bilateral tubal blockade demonstrated in 17 of the women while the procedure could not be completed in the four other women. Twenty-two of the women showed spillage of saline during the SIS procedure, of which 12/22 had previously been shown to have bilateral tubal blockade by HSG. Within six months after the procedure, six women had spontaneous intrauterine pregnancy one of whom was diagnosed with tubal blockade by both HSG and SIS.
Conclusion: This study has demonstrated the usefulness of SIS as part of the initial investigations for tubal factors in the management of subfertility. The procedure should be made accessible and available to the women who need it especially in developing countries with high burden of tubal factor infertility.