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Ultrasound images from a sonohysterogram can help find the cause of bleeding or problems with getting pregnant.
Unlike a hysterosalpingogram, a sonohysterogram doesn't use X-rays or an iodine dye. The test can be done in a doctor's office, a hospital, or a clinic.
Why It Is Done
It's usually done because a normal ultrasound has not found the cause of heavy bleeding, repeated miscarriages, or trouble getting pregnant.
This imaging test checks the inside of the uterus for such things as:
- An abnormal shape or structure.
- Abnormal growths or masses, such as fibroids or polyps.
- Scarring inside the uterus (adhesions).
A sonohysterogram may be more accurate than a hysterosalpingogram for finding fibroids and polyps.
How To Prepare
Schedule your test for when you won't be having your period. Your doctor may suggest that the test be done soon after your period ends and before your ovary releases an egg (ovulates). This timing allows your doctor to see the inside of your uterus better. It also avoids doing the test when you could be pregnant.
Your doctor may have you take an over-the-counter pain medicine, such as ibuprofen, about an hour before your test. This can help with cramps and pain during the test.
You may want to bring a sanitary pad. Some of the saline solution may leak out after the test. You also may have some slight bleeding.
How It Is Done
A sonohysterogram can be done in a doctor's office, a hospital, or a clinic.
Before the test, you empty your bladder. You then take off your clothes below the waist. You are given a gown or sheet to cover up with during the test.
For the test, you sit on the edge of a padded table. Then you lie back with your feet and legs supported by footrests.
A sonohysterogram is done in several steps.
- Transvaginal ultrasound. A thin ultrasound wand with gel on it is gently placed into your vagina. It will slowly be moved to take pictures from different angles and then is removed.
- Catheter placement. Next, your doctor places a tool called a speculum into your vagina. The speculum opens the vagina a little bit, allowing your doctor to see the cervix. Then a flexible tube (catheter) is put in the cervix or through the cervix into the uterus.
- Transvaginal ultrasound while the uterus is filled with fluid. The doctor then removes the speculum and places the ultrasound wand again. Onscreen, the ultrasound image shows the inside of your uterus while saline solution is injected through the tube into the uterus. Ultrasound images are taken and reviewed.
After the test, the ultrasound wand and then the tube are removed. Most of the saline solution will leak from your cervix and vagina.
How long the test takes
The test will take about 15 to 30 minutes.
How It Feels
You may feel some pressure as the transducer is put into your vagina. You probably will feel some cramping (like menstrual cramps) from the fluid being injected into your uterus.
There is a small chance of pelvic infection after a sonohysterogram.
The shape of the uterus is normal.
No objects (such as an intrauterine device, or IUD), tumors, or growths are seen in the uterus.
The uterus may have an abnormal shape or structure.
The uterus may show tissue (called a septum) that divides the uterus.
Current as of: February 23, 2022
Author: Healthwise Staff
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine
Kirtly Jones MD - Obstetrics and Gynecology
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