Wadhwa Leena, Rani Pooja, Bhatia Pushpa
Department of Obstetrics and Gynecology, ESI-PGIMSR, Basai Darapur, New Delhi, India.
Department of Obstetrics and Gynecology, Sharda Hospital, Greater Noida, Uttar Pradesh, India.
J Hum Reprod Sci. 2017 Apr-Jun;10(2):73-78. doi: 10.4103/jhrs.JHRS_123_16.
To compare the findings and diagnostic accuracy of Hysterosalpingography (HSG) and hysteroscopy in infertile women.
Prospective comparative study in a tertiary care Centre.
108 women with primary or secondary infertility were recruited. In all women after basic infertility workup, both HSG and hysteroscopy were performed.
Out of 108 women, in 3 women HSG couldn't be done and in one woman there was uterine perforation on hysteroscopy. HSG showed normal uterine cavity in 77.8% (81/105) women and abnormal in 22.85% (24/105). Hysteroscopy findings were normal in 70.09% (75/107) and abnormal in 29.91% (32/107). Hysteroscopy detected incidental findings in 15.38% (16/104) cases. HSG showed irregular uterine cavity in 14.15% (15/105) women but on hysteroscopy; normal cavity was present in 6 (40%) women and abnormality was detected in 9 (60%) women. The sensitivity, specificity, positive predictive and negative predictive value of HSG in evaluating uterine cavity abnormalities were 44.83% (95% confidence interval (CI); 0.26-0.64), 86.67% (95% CI; 0.76-0.93), 56.52% (95% CI; 0.34-0.76) and 80.25% (95%CI; 0.69-0.88). Positive likelihood ratio and negative likelihood ratio of HSG in detecting uterine cavity abnormality was 3.36 and 0.64 respectively. The agreement between HSG and hysteroscopy was 75%. This was statistically significant ( value = 0.001) with fair strength of agreement between HSG and hysteroscopy. (k value= 0.336).
Hysteroscopy should be performed in all infertile patients as it can detect significant number of incidental findings missed by HSG.
比较子宫输卵管造影（HSG）和宫腔镜检查在不孕女性中的检查结果及诊断准确性。
在一家三级医疗中心进行的前瞻性对照研究。
招募108例原发性或继发性不孕女性。所有女性在完成基本不孕检查后，均接受了HSG和宫腔镜检查。
108例女性中，3例无法进行HSG检查，1例在宫腔镜检查时发生子宫穿孔。HSG显示77.8%（81/105）的女性子宫腔正常，22.85%（24/105）异常。宫腔镜检查结果显示70.09%（75/107）正常，29.91%（32/107）异常。宫腔镜检查在15.38%（16/104）的病例中发现了意外情况。HSG显示14.15%（15/105）的女性子宫腔不规则，但在宫腔镜检查中，6例（40%）女性子宫腔正常，9例（60%）发现异常。HSG评估子宫腔异常的敏感性、特异性、阳性预测值和阴性预测值分别为44.83%（95%置信区间（CI）：0.26 - 0.64）、86.67%（95%CI：0.76 - 0.93）、56.52%（95%CI：0.34 - 0.76）和80.25%（95%CI：0.69 - 0.88）。HSG检测子宫腔异常的阳性似然比和阴性似然比分别为3.36和0.64。HSG与宫腔镜检查的一致性为75%。这具有统计学意义（P值 = 0.001），HSG与宫腔镜检查之间的一致性强度一般（kappa值 = 0.336）。
所有不孕患者均应进行宫腔镜检查，因为它能检测出大量HSG遗漏的意外情况。
