Comparison of hysterosalpingograms with laparoscopy in the diagnostic of tubal factor of female infertility at the Yaoundé General Hospital, Cameroon

  • Jean Dupont Kemfang Ngowa
  • Jean Marie Kasia
  • NGuefack-Tsague Georges
  • Victorine Nkongo
  • Charles Sone
  • Emmanuel Fongang

Abstract

Introduction: The objectives were to assess the diagnostic value of hysterosalpingography (HSG) with laparoscopy as gold standard in the evaluation of tubal patency and pelvic adhesions in women suffering from infertility. Methods: We conducted a comparative cross sectional study on 208 medical files of infertile women followed up at the Yaoundé General Hospital during a period of five years (December 2007 to December 2012). Tubal patency, hydrosalpinx and pelvic adhesions detected at HSG were compared with laparoscopic findings as the gold standard. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of HSG were calculated with 95% confidence interval (CI). Results: Mean age of the patients was 31.4± 6.45 years. Secondary infertility was the most frequent type of infertility (66.82%). HSG had a moderate sensitivity (51.0%; 95% IC. 37.5-64.4), high specificity (90.0 %; 95% IC.74.4-96.5), high PPV (89.3 %; 95% IC. 72.8-96.3) and a moderate NPV (52.9%; 95% IC. 39.5-65.9) in the diagnosis of bilateral proximal tubal occlusion. Concerning, distal tubal patency, HSG had a high sensitivity (86.8%; 95% IC. 76.7-92.9), low specificity (42.2%; 95% CI. 29.0-56.7), moderate PPV (69.4%; 95% IC. 58.9-78.2) and a moderate NPV (67.9%; 95% IC. 49.3-82.0) in the diagnosis of bilateral or unilateral distal tubal occlusion. However, HSG had a low diagnostic value (27.8%; 95%IC.18.8-39.0) in the pelvic adhesions. Conclusion: HSG is of limited diagnostic value in tubal factor infertility and is of low diagnostic value for pelvic adhesions.

Pan African Medical Journal 2015; 22

Author Biographies

Jean Dupont Kemfang Ngowa
Obstetrics and Gynecology Unit, Yaoundé General Hospital, P.O. Box 5408, Yaoundé, Cameroo; Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon
Jean Marie Kasia
Obstetrics and Gynecology Unit, Yaoundé General Hospital, P.O. Box 5408, Yaoundé, Cameroo; Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon
NGuefack-Tsague Georges
Biostatistics Unit, Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon
Victorine Nkongo
Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon
Charles Sone
Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon
Emmanuel Fongang
Radiology Unit, Yaoundé General Hospital, P.O. Box 5408, Yaoundé, Cameroon
Published
2016-08-15
Section
Articles

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eISSN: 1937-8688