Hysterosalpingography and Risks of HIV Dissemination in Women

Abstract

Hysterosalpingography (HSG) represents an important imaging procedure in the investigation of infertility and may be associated with high pregnancy rate as a therapeutic effect. Whereas less traumatic and infection-free techniques of HSG have been embraced in the developed countries using disposable catheters, the traditional method which employs sterilizable metal cannula with potential to cause tissue laceration and infection dissemination continues to be used in Nigeria. This report attempts to discourage the use of such shared instrumentation in order to prevent horizontal dissemination of HIV infection among female patients. Over a seven month period, 746 HSGs were performed using predominantly sterilizable metal cannula or disposable catheters when the former fails. Analysis of the age of patients, type of instrumentation and outcome of the HSG procedure was undertaken and tabulated. The HSG workload out of a total radiologic procedure of 4039 is 746 (18.47%). The mean age of the patients is 33 years. Of the 707 HSGs carried of with sterilizable metallic cannula, contrast medium reflux into the pelvic veins was recorded in 133 (17.83%) cases, whereas this phenomenon was absent in instrumentation with disposable catheters. Venous intravasation during HSG procedure carries a risk of horizontal dissemination of HIV virus when sterilizable metallic cannula is employed. This may be prevented through the use of disposable catheters.

Keywords: Hysterosalpingography, HIV, Infection, Risk

Nigerian Hospital Practice Vol. 2 (2) 2008: pp. 37-41