The value of saline salpingosonography as a surrogate test of tubal patency in low-resource settings.
BACKGROUND
Tubal factor, which accounts for 15-30% of infertility in all women, is common in developing countries with high rates of pelvic inflammatory disease but limited resources. It is possible to outline the fallopian tubes by injecting isotonic saline transcervically during transvaginal ultrasound scanning of the pelvis, and both color flow Doppler and 3-dimensional scanning modes have been employed to improve visualization of the tubes, with varying success.


METHODS
We investigated the value of saline salpingosonography (SSG), using 2-dimensional transvaginal ultrasound scanning, as a screening test of tubal patency in 113 women by comparing SSG findings to those at HSG or laparoscopy.


RESULTS
The findings at SSG correlated well with the results of HSG or laparoscopy, with an overall concordance of 82.5%. SSG was more accurate at diagnosing patent tubes than blocked tubes and was well tolerated. The results are, however, unreliable when it is difficult to inject the saline and when the patient experiences severe pain during the procedure.


CONCLUSIONS
SSG is a useful screening tool for investigating infertility, particularly in low-resource settings.
Hoffman
L
L
Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, United Kingdom.
Chan
K
K
Smith
B
B
Okolo
S
S
D000328:Adult; D000465:Algorithms; D004311:Double-Blind Method; D005186:Fallopian Tube Patency Tests / Q000379:methods; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods; D007247:Infertility, Female / Q000000981:diagnostic imaging*; D008137:Longitudinal Studies; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012965:Sodium Chloride; D014463:Ultrasonography; D016387:Women's Health
D012965:Sodium Chloride