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Новый способ поэтапной контрастной гистеросальпингосонографии для оценки проходимости и функциональной состоятельности маточных труб

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Литература:

A New Procedure of Testing a Patency and Functional State of Fallopian Tubes by the Way of Step$by$step Contrast Hysterosalpingography

A stepwise procedure of hysterosalpingography with hydrogen peroxide as a intrauterine sonopositive contrast agent was proposed. As a preliminary exam all patients underwent a transvaginal ultrasonography, then, the catheterization of uterine cavity under local intrauterine jell anesthetic was performed. At the first step of the procedure the sonopositive saline solution was injected (infused) through the catheter. Dimensions, border, and abnormalities of the uterine cavity, as well as the mode of saline infusion easy or impediment), and its presence in the retrouterine space were assessed. Tube filling without the saline exit into the abdominal cavity allowed distinguishing the tube blockage in fimbrial part. At the second step of the investigation 0,15–0,33% hydrogen peroxide solution was administrated as a positive ultrasound contrast agent. Gas microbubbles contrasting the uterine cavity, cornual regions, and tube lumens were estimated as well as a passage of contrast agent within tube lumens (during 10 sec and a longer time) and its appearance in the abdominal cavity. At the third step, 3–6 min after removal of the catheter and the contrast medium from the uterine cavity, one could observe fragmentation and movement, of the contrast agent, and so the gas bubbles flow from the tube into the uterine cavity and, if possible, the uterinepetal motions of tubes were assessed. The advantages of the present diagnostic tool were discussed in detail. It had high diagnostic accuracy, it didn't create complications and had no contradictions, and it might be repeated during case monitoring. This painless, atraumatic, and low-invasive technique simplifies an examination procedureof women with primary and secondary infertility. It is relatively inexpensive, and so it is available for majority of patients and clinics.

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