Ultrasound-Sonohysterogram(SHG)

What is Sonohysterogram?

Ultrasound is a non-invasive medical technique of examination which produces images of the inside of our body using sound waves. This helps the doctors in diagnosis and treatment of medical conditions. Sonohysterogram is a minimally invasive process of imaging the inside of the uterus. It shows and records the structure, shapes and internal organ movements inside the uterus.  

It does not use radiation like in X-rays. It uses a fluid called saline which is filled in the uterus through a thin, flexible tube called a catheter and a device called a transducer covered with a special gel is inserted in the vagina. The gel helps in sending the sound waves from the device and the saline in the uterus helps in forming images from echoes of the sound. It is also called Saline Infusion Sonography.

A patient should not conduct a sonohysterogram if she is pregnant or suffers from Pelvic Inflammatory Disease (PID).

The sonohysterogram should be performed immediately after the period has ended and before the start of the ovulation process i.e. days 6 to 11 days of the menstrual cycle. During these times the endometrium is the thinnest and this helps in seeing things more clearly. In the postmenopausal period, there are no such restrictions, it can be done at any time.

Symptoms for which Sonohysterogram is Advised

Sonohysterogram is performed by the doctor if the following symptoms are exhibited in the patient –

  • When the patient has heavy bleeding (more than usual) during the period
  • When the patient’s period lasts for a longer duration than normal duration.
  • When the patient suffers from continuous pelvic pain
  • When a patient is unable to get pregnant after many attempts for about a year
  • When the patient had multiple miscarriages

Causes of Sonohysterogram      

The Sonohysterography shows the structures, shapes and internal part movement very clearly. This helps it in identifying the causes that show the above symptoms, which are –

  • Uterine Polyps
  • Uterine Fibroids
  • Scarring inside your uterus
  • The untypical shape of the uterus
  • Endometriosis
  • Fallopian tube blockage
  • Endometrial Cancer

When to visit a doctor?

It is in one’s benefit to have a medical check at regular intervals but if a patient experiences any of the symptoms mentioned above she should immediately visit the doctor.

Preparation for Sonohysterogram

 There are various checklists which need to fill before the test by the patient. They are -

  • Ensure she doesn’t suffer from any infection or that she is pregnant
  • Take medicine to control irregular bleeding
  • Perform normal day activities like eating, drinking, and taking regular medicines
  • Take pain medicine in advance to overcome any discomfort during the test
  • Ensure the test is done in a favourable duration for better results
  • Ensure the patient wears comfortable clothes and wears a pad to absorb after the test discharge

Procedure of Sonohysterogram

The pieces of equipment used in this test are a computer, video monitor, Transducer, catheter, gel and saline fluid.  Transducer, a small handheld device like a microphone. It sends inaudible, high-frequency sound waves and listens to the echoes it sends back. The gel is applied to the area before the transducer is used. The gel facilitates sound waves to travel back and forth. The flexible tube Catheter fills the uterus with saline. The saline expands the uterus for a clear view. The computer creates the image using loudness, frequency and time taken for sound to return to the transducer.

The test takes thirty minutes. The examiner may ask you to empty the bladder to collect samples for pregnancy tests. The procedures for conducting the exam are as follows –

  • The test starts with abdominal and transvaginal ultrasound without saline.

Transducer covered with lubricant or gel is inserted into the vagina. It will provide images of the uterus. The examiner will move it to have a view from different angles and record it. The same procedure will be done from the top of the abdomen.

  • After the above step, saline is added to the uterus.

The saline is added through the catheter into the uterus. Saline expands the uterus which will help in getting a better and clear view of the inside.

  • Now transvaginal ultrasound is conducted with saline.

The same process of examination which was done without saline ultrasound is conducted here again with saline.

After Sonohysterogram

 After the procedure, the patient may experience cramping, vaginal discharge or light spotting.  This is normal. If the problem persists, visit your doctor.

1. What is ultrasound?

Ultrasound is a non-invasive medical technique of examination which produces images of the inside of our body using sound waves.

2. Does SHG use radiation?

It does not use radiation like in X-rays. It uses inaudible, high-frequency sound waves.

3. What is the duration of the test?

The duration of the test is 30 minutes.

4. Is there any risk involved with the test?

No, there is no risk involved.

5. Who should not perform the test?

The test should be avoided if the patient is pregnant or have an infection.

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