PREGNANCY-BIRTH Messages for May, 1999: Re: hysterosonogram

Re: hysterosonogram

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Sun, 30 May 1999 07:36:34 -0500 (CDT)

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At Sat, 29 May 1999, Valerie wrote: >
>My Dr. tried three times to give me a saline infused sonogram
>yesterday, but the saline just wouldn't run into my uterus. Since I
>have an unusually sensitive cervix he is now recommending general
>anesthesia and a hysterosonogram (sp?).

It's very hard to be a backseat gynecologist, so your doctor is in the best position to gauge how far to go with your workup. However, here are some thoughts:

A paracervical block, which is novocaine placed around the cervix, will often numb the cervix extremely well. Then your doctor can carefully dilate the cervix to let the small catheter go in. If the problem is that the catheter fits, but the saline runs out, he should probably use a balloon catheter to prevent the saline from running out. These are small and usually go in fine.

It is extremely unusual to need general anesthesia for an HSG (hysterosalpingogram), and some insurance companies may not even cover this. But, if your doctor has tried a saline ultraound and you were in obvious pain, and were, for example, crying or moving a lot because of the pain, then your doctor is not going to want to torture you by trying again. Saline ultrasounds are almost always painless or only mildly uncomfortable, so if your cervix is very sensitive then your doctor is on the right track offering you a procedure under anesthesia. An epidural should be fine. An HSG usually lasts about 3-10 minutes. Rather than general anesthesia, I would usually suggest an IV sedative, then a paracervical block. I can't imagine that this would not provide more than enough analgesia for an HSG. That way, you should not be in pain and can have the procedure completed.

Good luck with everything.

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL http://home.mpinet.net/dahmd

The above is intended for general medical education, and is not for specific medical advice. I apologize, but I am unable to answer personal e-mail due to time constraints.

Next message: William F. von Almen, II, MD: "Re: tained placental fragments"
Previous message: Soundaravalli: "Re: Breastfeeding Questions"
In reply to: Cindy: "Re: Leaking amniotic fluid at 17 weeks? Thanks Dr. Hill!"

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