Sonohysterography, also referred to as hysterosonography or saline infusion sonography, is a type of pelvic ultrasound procedure that involves scanning the interior of a woman’s uterus using a transvaginal probe inserted into the vagina. To obtain ultrasound images of this area, a baseline scan is performed after which the uterus is injected with sterile saline fluid and rescanned. The saline fluid enlarges the uterus and reveals its endometrial lining so that this can be properly scanned. The procedure is used to investigate abnormal vaginal bleeding caused by fibroids, polyps, endometrial atrophy, scarring, malignant masses or lesions, and congenital problems.
Sonohysterography is also helpful in investigating the cause of pelvic pain, infertility and multiple miscarriages. When saline and air are both injected, the procedure allows for the investigation of air bubbles in the fallopian tubes that can help identify abnormalities in these structures. Ultrasound can also be used to study blood-related issues such as clots, the blood supply in tumors and polyps, pelvic aneurysms, and pelvic varicose veins.
Limitations of Sonohysterography
Sonohysterography is not usually possible in cases where women have acute pelvic inflammatory disease and is not performed during pregnancy. The procedure is usually performed one week after menstruation to minimize infection risk and because this is the best time in the menstrual cycle to assess the endometrium or uterine lining. The procedure may be difficult to complete on women with cervical stenosis or narrowing. Furthermore, the possibility exists that the saline injection may not expand the uterus enough to get good images. This can happen when uterine scarring or fibroids have destroyed part of the uterine cavity.