Department of Obstetrics and Gynecology, Máxima MC, Veldhoven/Eindhoven, the Netherlands; Department of Reproductive Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction and Development Amsterdam, the Netherlands; School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands.
Department of Reproductive Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction and Development Amsterdam, the Netherlands.
Reprod Biomed Online. 2021 Jun;42(6):1119-1129. doi: 10.1016/j.rbmo.2021.03.014. Epub 2021 Mar 23.
Recent meta-analyses have shown that a hysterosalpingography (HSG) with oil-based contrast increases pregnancy rates in subfertile women. However, the frequency of complications during or after an HSG with oil-based contrast in subfertile women and/or their offspring is still unclear. This systematic review and meta-analysis, without restrictions on language, publication date or study design, was performed to fill this knowledge gap. The results show that the most frequently reported complication was intravasation of contrast, which occurred in 2.7% with the use of oil-based contrast (31 cohort studies and randomized controlled trials [RCT], 95% CI 1.7-3.8, absolute event rate 664/19,339), compared with 2.0% with the use of water-based contrast (8 cohort studies and RCT, 95% CI 1.2-3.0, absolute event rate 18/1006). In the cohort studies and RCT there were 18 women with an oil embolism (18/19,339 HSG), all without serious lasting consequences. Four cases with serious consequences of an oil embolism were described (retinal oil embolism [n = 1] and cerebral complaints [n = 3]); these reports did not describe the use of adequate fluoroscopy guidance during HSG. In conclusion, the most frequently reported complication after an HSG with oil-based contrast is intravasation occurring in 2.7%. In total four cases with serious consequences of oil embolisms in subfertile women were published.
最近的荟萃分析表明，油性造影剂子宫输卵管造影（HSG）可提高不孕女性的妊娠率。然而，油性造影剂 HSG 在不孕女性及其后代中发生的并发症的频率尚不清楚。本系统评价和荟萃分析不限制语言、出版日期或研究设计，旨在填补这一知识空白。结果表明，最常报告的并发症是造影剂外渗，使用油性造影剂时发生率为 2.7%（31 项队列研究和随机对照试验[RCT]，95%CI 1.7-3.8，绝对事件率 664/19339），而使用水性造影剂时发生率为 2.0%（8 项队列研究和 RCT，95%CI 1.2-3.0，绝对事件率 18/1006）。在队列研究和 RCT 中，有 18 名女性发生油性栓塞（18/19339 次 HSG），均无严重持续后果。描述了 4 例严重油性栓塞后果的病例（视网膜油栓塞[1 例]和脑主诉[3 例]）；这些报告没有描述在 HSG 期间使用适当的透视引导。总之，使用油性造影剂 HSG 后最常报告的并发症是发生率为 2.7%的造影剂外渗。总共发表了 4 例在不孕女性中发生严重油性栓塞后果的病例。
