Sonohysterography, also known as saline ultrasound, is a technique in which fluid is injected through the cervix into the uterus, and an ultrasound is used to make images of the uterine cavity. With a sonohysterogram, the fluid shows more detail of the inside of the uterus than when ultrasound is used alone. The procedure can be done in a health care provider’s office, hospital, or clinic. It usually takes about 15 minutes.

Why a sonohysterogram is done

Sonohysterograms can find the underlying cause of many problems, including abnormal uterine bleeding and repeated miscarriages. It is also used as an infertility test. A sonohysterogram may be ordered when a woman has had a normal ultrasound exam but is still having symptoms.

This procedure can detect the following conditions:

  • Abnormal growths inside the uterus, such as fibroids or polyps
  • Scarring inside the uterus
  • Abnormal uterine shape
  • A Sonohysterogram is also is done before and after some surgical procedures

When a sonohysterogram (saline ultrasound) is done

The saline ultrasound procedure will be scheduled when you are not having your menstrual period. If you are bleeding, the results may not be as clear. The test may be postponed until the bleeding stops. The procedure is not done if you are or could be pregnant, or if you have a pelvic infection or pelvic inflammatory disease. You may be given a urine test to rule out pregnancy.

The Sonohysterogram Procedure

  • Preparation
  • Sonohysterography is done when your bladder is empty. You will be asked to undress from the waist down and lie on an exam table. Your healthcare provider may do a pelvic exam to check if you have any tenderness or pain. In some situations, you may be given antibiotics.

  • During the procedure
  • A sonohysterogram has two parts. A transvaginal ultrasound exam is done first. Next, a fluid is injected through the cervix and flows into the uterus. Then, an ultrasound exam is done again.

    In a transvaginal ultrasound exam, an ultrasound transducer — a slender, handheld device — is placed in the vagina. It sends out sound waves that are used to make images of the internal organs. These images are shown on a screen.

    After the first transvaginal ultrasound exam, the transducer is removed. A speculum is then placed in the vagina to hold the vagina open. The health care provider passes a swab through the speculum to clean the cervix.

    Next, a thin tube called a catheter is inserted through the vagina. It is placed in the opening of the cervix or in the uterine cavity. The speculum is then removed.

    The transducer is placed in the vagina again and a sterile fluid is slowly passed through the catheter. Cramping may occur as the fluid goes into the uterus. A transabdominal ultrasound exam also may be done while the fluid is passed into the uterus. In this type of ultrasound exam, a transducer is moved over the abdomen.

    When the cavity is filled with fluid, ultrasound images are made of the inside of the uterus and the uterine lining.

  • After the saline ultrasound procedure
  • Most women are able to go home right away and return to their normal level or activity that day. Cramping, spotting, or a watery discharge may occur as a result from the procedure. The procedure is safe, but there is a rare risk of pelvic infection. Call your healthcare provider if you have any pain, fever, or change in discharge after the procedure.

    If you need an infertility test or you have abnormal uterine bleeding, contact us for more information and to schedule your saline ultrasound today.