Avulsion of the uterine cervix complicating hysterosalpingography in a hypo-oestrogenic woman

Abstract

Hysterosalpingography (HSG) is used increasingly as a diagnostic tool in many developing countries. HSG serves as a valuable firstline screening test for the evaluation of infertile women and it may obviate the need for the more traumatic laparoscopy and dye test. The sensitivity of HSG for demonstrating abnormalities of the upper reproductive tract (uterus and tubes) has been reported to be as high as 90%. One important advantage of HSG over laparoscopy is its lower rate of complications especially in developing countries where competency in diagnostic laparoscopy has not been developed to any considerable extent. Indeed reports of complications resulting from HSG procedures are minor and few in the world literature. We report here a case of complete avulsion of the uterine cervix as a severe complication of HSG in a woman with evidence of hypooestrogenism. To date we have no evidence that such a complication of HSG has ever been reported in the literature. We believe that low oestrogen levels could render the cervical tissues susceptible to this rare complication of HSG. (excerpt)