TITLE:
Diagnostic Accuracy of Hysterosalpingography in the Identification of Intrauterine Adhesions in Infertile Women in a Referral Centre, Southern Nigeria
AUTHORS:
Inusa Amike, Emmanuel Okwudili Oranu, Tamunomie Kennedy Nyengidiki, Enighe W. Ugboma, Kingsley Vademe Oriji
KEYWORDS:
Intrauterine Adhesion, HSG, Hysteroscopy, Port Harcourt
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.2,
February
24,
2023
ABSTRACT: Background: Examination
of the endometrial cavity is crucial in the management of infertile women. This
evaluation is done by Hysterosalpingography (HSG) in the University of Port
Harcourt Teaching Hospital. The diagnostic value and accuracy of
hysterosalpingography varies in various centres and has not been assessed in
the University of Port Harcourt Teaching Hospital (UPTH), hence this study. Methodology: A prospective cross sectional study done among 101 infertile women at the
gynaecology clinic of the UPTH from December 2018 to July 2019.
Socio-demographic data of women who met the eligibility criteria were collected. Their hysterosalpingographic
and outpatient hysteroscopic findings were statistically analyzed using IBM
SPSS for windows version 20.0. The validity and reliability statistics of
hysterosalpingography for the identification of endometrial adhesions were
determined and significance was reported at p-value Result: The respondents were
all married, 66.3% of them were nulliparous, while 54.5% were above 35 years of
age. Most, 93.1% of the studied group had at least secondary education
and had duration of infertility of more than 2 years. There was a moderate strength of agreement in the diagnostic
accuracy of HSG with hysteroscopy in the diagnosis of intrauterine adhesions;
showing sensitivity and specificity of 59.6% and 90.9% respectively. The
accuracy of HSG in the identification of intrauterine adhesions in this study
was 73.3%. The agreement in the diagnostic accuracy of HSG using Hysteroscopy
as a gold standard for intrauterine adhesions was therefore moderately
significant (k = 0.482). Conclusion: HSG had an overall fair strength of
agreement with office hysteroscopy in the identification of intrauterine
adhesions. It is a specific but not a sensitive predictor of intrauterine
adhesion.