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What is a Saline Sonogram?

What is a Saline Sonogram?

A Saline Sonogram a most detailed assessment of the uterine cavity. Basic ultrasound can provide great information about the uterine muscle/uterine wall and about the ovaries. Basic ultrasound can easily identify uterine fibroids, ovarian cysts, and normal ovarian follicles. The uterine cavity is buried centrally within the uterus, and is composed of fleshy tissue that is hormonally sensitive and can easily hide polyps unless a Saline Sonogram is performed.  The Saline Sonogram can also give more detailed information about the exact location of a fibroid to determine whether it might interfere with an early pregnancy or whether it is just an innocent bystander contained fully within the uterine wall.

How Do I Prepare for a Saline Sonogram?

The best information is obtained when the test is timed to the menstrual cycle. It is best to perform after the bleeding stops and prior to an ovulation.  For most people, the would be cycle day 6 to cycle day 12, with cycle day 1 being the first day of continuous blood flow. As the procedure can cause moderate to strong cramps, it is best to pretreat with a high dose of Motrin, or Advil, or Ketorolac.  With the proper pre-treatment, it is a very manageable office procedure. Dr. Moomjy will decide with you which would be the best pre-treatment based on the level of cramping and treatment you take for your routine periods. The patient should have negative/normal cervical cultures prior to scheduling in order to be sure that there is negligible risk of a procedure related infection.

How Exactly Does the Saline Get into the Uterus?

A uterine catheter is a thin, sterile tube, 2 millimeters in diameter, that can access the uterus once a speculum is placed.  For the patient, this part of the procedure feels like a Pap Test. The speculum is removed, the catheter is kept in place, and a vaginal ultrasound probe is placed to visualize the uterine cavity.  As the Saline slowly fills the uterine cavity, the walls of the uterus separate, in a manner similar to a 6-week pregnancy. The saline will easily outline any polyps, and the boundaries of any fibroids that have entered the uterine cavity.  If the saline ultrasound shows normal views, we know that there are no polyp, fibroids, or scar tissue. We also know that the uterus is normally formed without any septum.

When Can I Resume Normal Activities?

Right away! But do wear a pad that day as there can be a little leakage of residual saline after the procedure is completed.

Are There Any Other Terms for The Saline Sonogram?

Yes, of course. In Medicine, we like to have multiple terms for everything.  This test has also been called: Saline Infusion Ultrasound; Hysterosonogram; and SIS.

If I Do an HSG, Do I Need a Saline Sonogram?

On occasion a Saline Songram may be suggested if the HSG has given an indeterminant result, especially of the uterine cavity.  The Saline Sonogram does not give reliable information about tubal anatomy, although if there is fluid behind the uterus, we know at least one tube is open.  The HSG gives more detailed information about tubal anatomy and function.

Maureen O'Brien Moomjy, MD, FACOG

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