Isfahan University of Medical Sciences Dissertation defense meeting Resident of Gynecology and Obstetrics Company Logo Evaluation of efficacy of transvaginal sonography with hysteroscopy in the assessment of tubal patency in infertile women regarding diagnostic laparoscopy ID: 780203
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Slide1
In The Name Of God
Slide2Isfahan University of Medical Sciences Dissertation defense meetingResident of Gynecology and Obstetrics
Company Logo
Slide3Evaluation of efficacy of
transvaginal
sonography with hysteroscopy in the assessment of tubal patency in infertile women regarding diagnostic laparoscopy in patients referred to ShahidBeheshti hospital during the years 2015-2016
Slide4Provider
:
Dr. Maryam Nazemi Supervisors : Dr.Farahnaz Mardanian Dr. Safora Rouholamin
Slide5Prevalence
25%
TUBAL factor
Infertility
Slide6TUBAL PATENCY
LAPARASCOPY
HSG
Slide7HSG
HSG is less invasive and widely used tool to detect fallopian tubal patency.
It used radiation and is associated with some complications such as allergic reactions and pain
Slide8The role of laparoscopy in the evaluation of infertility is controversial. Laparoscopy is invasive and expensive. Findings at laparoscopy usually do not alter the initial treatment of the infertile couple.
Laparoscopy is indicated in women in whom endometriosis or pelvic adhesions is suspected based on physical examination
.www.themegallery.comCompany Logo LAPARASCOPY:
Slide9LAPARASCOPY
Invasive examination in combination with some necessary items, such as an equipped operating room , general anesthesia, laboratory test and trained staff.
Slide10Transvaginal
Sonography with Hysteroscopy
Slide11Method
:
Cross sectional study:Infertile women referred to shahid beheshti hospital the years 2015_2016
Slide12PATIENT WITH ABNORMAL UTERINE BLEEDING
PATIENT WITH PELVIC INFECTION
EXCLUDED
CRITERIA
Text
Text
Slide13Diagram
49
SAMPLE SIZE
TextTextTextTextTextText
Slide14Method
A) TVS examination of pelvic was perform.
B) Hysteroscope with 30 optic and 3/5mm external sheet was employed. C) N/S was used as the distension media Intrauterin pressure was maitained 80_100 mmhg.
Slide15Method
D)TVS was performed with 15 min of finishing hysteroscopy.
E)Then laparascopy was performed.Company Logo
Slide16www.themegallery.com
Slide17Method
The kappa coefficient was employed to assess the agreement between TVS after HSC and laparoscopy.
The following cut-off points were used for the interpretation of kappa: < 0.20, very poor; 0.21–0.40, poor; 0.41–0.60, moderate; 0.61–0.80, good and ≥ 0.81, very good.
Slide18Chi-square and Mann-Whitney tests were used to compare qualitative and quantitative variables among the groups, respectively.
All of the statistical analysis was performed using
MedCalc software version 15. A P-value less than 0.05 was considered significantCompany Logo
Slide19RESULTS
Slide20
Slide21Slide22There was a very good agreement between TVS after HSC and laparoscopy
(Kappa coefficient = 0.935, 95% CI: 0.81, 1.00).
Slide23A)The sensitivity of TVS after HSC was 100% (95% CI: 66.37, 100).
B) and specificity was 97.50% (95% CI: 86.84, 99.94). C)with a PPV of 90% (95% CI: 55.50, 99.75). D)and NPV of 100% (95% CI: 90.97, 100).
Slide24DISCUSSION
Slide25Diagram
NHHHHHHH
اتا
u .Allam et al 2014
Role of hysteroscopy in the
evalution
in tubal patency
Youssef
G,et
al
2015
Combined TVS and diagnostic hysteroscopy in the assessment of tubal patency
Slide26www.themegallery.com
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h
Diagnosis of fallopian tube patency by using hysteroscopy with ultrasound compared HSG.Yildizhan et al2010
Slide27CONCLUSION
Slide28Our results with confirmation of the other researches , could propose TVS after HSC as an accurate, uncomplicated, quick with low cost outpatient diagnostic test for detecting fallopian tubal patency.
Slide29Further studies in large scale are required to assess reliability and precision of TVS after HSC. In order to complete the finding of the present study, taking 3D
sonography
for accurate diagnosis is suggested.
Slide30Thanks for your attention
Slide31Further studies in large scale are required to assess reliability and precision of TVS after HSC. In order to complete the finding of the present study, taking 3D
sonography
for accurate diagnosis is suggested.
باتشکر فراوان اززحمات اساتید گرامی وتبریک روز استاد به همه اساتید گرانقدر