Relationship between Abnormal Cervical Findings and Abnormal Results at Hysterosalpingography in Infertile Women

Background: Hysterosalpingography is an investigative modality used in the evaluation of the uterine cavity, fallopian tubes, and adjacent peritoneal cavity following the injection of contrast material through the cervical canal.

Objective: To determine the relationship between abnormal cervical findings and abnormal results at hysterosalpingography in infertile women.

Materials and Methods: This descriptive, cross-sectional study conducted at the Obstetrics and Gynaecology, and Radiology Departments of four health institutions in Bayelsa State, Nigeria, between June and December, 2022. Hysterosalpingography was done for 332 infertile women, after obtaining written informed consent. Data were entered into a pre-designed proforma, and analysed using Statistical Product and Service Solutions (SPSS) version 25.0. Results were presented in frequencies and percentages for categorical variables, and mean and standard deviation for continuous variables.

Results: Cervical finding was normal in only 49.7% (n=165) of the participants undergoing HSG. The abnormal cervical findings include deformed (27.7%), hyperaemic (5.7%), dull (5.7%), hard (5.7%) and short (5.4%) cervix. There was a statistically significant relationship between abnormal cervical findings during HSG and tubal blockade (ꭓ2 = 196.7; p – 0.001), presence of salpingitis (ꭓ2 = 41.1; p – 0.001), peritubal adhesion (ꭓ2 = 19.9; p – 0.001) and intrauterine adhesion (ꭓ2 = 35.62; p – 0.001).

Conclusion: Intrauterine adhesion, salpingitis, tubal blockade and peritubal adhesion on HSG are associated with some abnormal cervical findings in about half of infertile women in this study. The same pathological processes responsible for injury to the upper genital tract and tubal infertility may have caused injury to the cervix in the group of women.