Velázquez CG, Zamora RML, Castro LJL, Mondragón AHL, López OCS, Téllez VS

Language: Spanish
References: 12
Page: 78-82
PDF size: 77.82 Kb.

ABSTRACT

Background: The uterine cavity is the site where the embryo is implanted in the normal way. It is vital the correct evaluation of the uterine cavity to rule out or detect changes that may affect the implementation and, if there is a disease, to perform corrective surgical treatment. The three most popular test for evaluating the uterine cavity are: hysterosalpingography, sonohysterography and hysteroscopy.
Objective: To determine the effectiveness of hysterosalpingography and sonohysterography compared with hysteroscopy in the evaluation of the uterine cavity of patients with reproductive problems.
Patients and method: A comparative, transversal, analytical and retrolective study was performed in 68 patients with reproductive problems. We calculated: sensitivity, specificity, positive predictive value (PPV) and negative (NPV), likelihood ratio for a positive result (LR+) and likelihood ratio for a negative result (LR-) of hysterosalpingography and sonohysterography to evaluate the uterine cavity. Hysteroscopy is considered the gold standard.
Results: Hysterosalpingography in the evaluation of the uterine cavity had sensitivity: 37% (CI 95% 0.24-0.51), specificity: 90.9% (CI 95% 0.72-0.97), PPV: 89% (CI 95% 0.68-0.97), NPV: 40% (CI 95% 0.28-0.54), positive likelihood ratio: 4.06 (CI 95% 1.02-16.06), negative likelihood ratio: 6.9 (CI 95% 0.53-0.89) and false negatives: 29%. To evaluate the uterine cavity sonohysterography showed sensitivity: 80.4% (CI 95% 0.66-0.893), specificity: 90% (CI 95% 0.72-0.97), PPV: 94% (CI 95% 0.83-0.98), NPV: 69% (CI 95% 0.50-0.82), positive likelihood ratio: 8.84 (CI 95% 2.34-33.42), negative likelihood ratio: 0.215 (CI 95% 0.11-0.39) and false negatives: 9%.
Conclusions: Hysterosalpingography has a lower diagnostic effectiveness that sonohysterography evaluating the uterine cavity of patients with reproductive problems. The sonohysterography may be the method of initial evaluation or complementary as it is simple, minimally invasive, less uncomfortable for the patient, low cost, and with a similar diagnostic effectiveness of hysteroscopy.

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