Sonohysterogram (SHG) or Saline-Infusion Sonography (SIS)

Pre- and Post-Operative Instructions

A saline-infusion sonogram (SIS) [also known as a sonohysterogram (SHG)] is a specialized ultrasonic examination utilizing saline solution to enhance visualization of the endocervical canal and the endometrial cavity. The purpose of this test is to determine the internal architecture of the endometrial cavity. The procedure is typically performed by our Physician Assistant, Dana Paravella, RPA-C or our Nurse Practitioner, Tamara Scheilding, FNP, when done for ‘screening’ purposes, but may be performed by Dr. Horvath, especially if it is being performed as a part of a preoperative evaluation.

The SIS should be performed during the week following the last day of the menstrual period. To schedule your SIS, call our fertility staff as soon as you get your menses.

The procedure is associated with mild to moderate cramping for most patients. We recommend that about one hour prior to the procedure you take ibuprofen 600-800 mg or whatever medication you take for menstrual discomfort. If you are generally extremely anxious about procedures, discuss this with our fertility nursing staff when you are scheduling the procedure, and we will prescribe an anxiety-relieving drug for you. (In this case, you will need to sign your procedure consent prior to taking this medication, and you will also need someone to drive you home from the procedure. Additionally, you should take a broad-spectrum antibiotic (typically vibramycin [Doxycycline] on the day of the procedure (usually 1 pill before, and one after the procedure). If you have not received a prescription, let the nursing staff member know this when scheduling the procedure; have your pharmacy telephone number available, and the prescription will be called-in for you.

The SIS is done in our office. Arrive 15 minutes early for your appointment. You will be asked to empty your bladder, and will be directed to our ultrasound exam room. You will be asked to undress from the waist down. After signing your consents, you will then be asked to lay down on the examination table like for a routine GYN exam. A speculum will then be inserted into the vagina. This may feel cold and cause some pressure. The cervix and vagina are then cleansed with salt-water (saline). This may feel cold and scratchy. Try not to hold your breath because this increases muscle tension and discomfort. Concentrate on breathing slowly and deeply in through your nose and slowly blowing out through your mouth. Do not breathe too fast, because you may hyperventilate and get dizzy. A plastic catheter is guided into the cervical opening and lower uterus and the speculum is removed. This may cause cramping. The ultrasound probe is then placed into the vagina. The saline solution is slowly injected into the uterus. At the conclusion of the test, the ultrasound probe and catheter will be removed from your vagina, and you may dress and resume normal activity.

 

There may be some slight bleeding or spotting. Please bring a pad with you to wear home. Infections are rare, especially with the antibiotic prophylaxis, but if you feel feverish, take your temperature at home. If it is over 100.4 degrees F, please call the office immediately. You may want to have someone available to drive you in case you feel uncomfortable after the procedure. If you have any questions regarding the procedure, please contact your primary nurse.

 

Additional information can be found at: http://www.asrm.org/Patients/FactSheets/SHG.pdf