Hysterosalpingogram

The two main indications for this examination are infertility and recurrent abortion. Watertight cannulation of the cervix is performed and aqueous contrast medium is injected to outline the uterus and uterine tubes. Some authorities use oil-based contrast, but granuloma formation and a flare-up of any pelvic infection may result. The narrowest point of the Fallopian or uterine tube is at the entrance to the uterine cavity. The widest point is at the abdominal end, the infundibulum, before it opens into the peritoneal cavity.

Free spillage of contrast into the pelvic cavity is an important sign and should be distinguished from loculated spill due to pelvic inflammatory disease. When possible, this examination should be performed 7-10 days following menstruation as earlier in the cycle, venous intravasation may result, and later on in the cycle, accidental fetal irradiation may occur.