ACOG technology assessment no. 8: Sonohysterography

The primary goal of sonohysterography is to visualize the endometrial cavity in more detail than is possible with routine transvaginal ultrasonography. The procedure consists of the transcervical injection of sterile fluid under real-time ultrasound imaging. The indications for sonohysterography include, but are not limited to, the evaluation of abnormal uterine bleeding; uterine cavity, especially with regard to uterine leiomyomas,polyps, and synechiae; abnormalities detected on transvaginal ultrasonography,including focal or diffuse endometrial or intracavitary abnormalities;congenital abnormalities of the uterus; infertility; and recurrent pregnancy loss. The procedure should not be performed in a woman who is pregnant or who could be pregnant or who has an existing pelvic infection or unexplained pelvic tenderness. Physicians who perform or supervise diagnostic sonohysterography should be skilled in vaginal ultrasonography and transcervical placement of catheters; should have training, experience, and demonstrated competence in gynecologic ultrasonography and sonohysterography; and should keep careful records. Portions of this document were developed jointly with the American College of Radiology, the American Institute of Ultrasound in Medicine, and the Society of Radiologists in Ultrasound.