TY - JOUR
T1 - Safety of oil-based contrast medium for hysterosalpingography
T2 - a systematic review
AU - Roest, Inez
AU - Rosielle, Kimmy
AU - van Welie, Nienke
AU - Dreyer, Kim
AU - Bongers, Marlies
AU - Mijatovic, Velja
AU - Mol, Ben W.
AU - Koks, Carolien
N1 - Acknowledgements
We would like to thank Mr B de Vries, Clinical Librarian at the Máxima MC for his assistance in developing the search strategies and his perseverance in retrieving the old manuscripts and Mrs J Dieleman for her statistical assistance. We want to thank our colleagues who helped to translate the non-English articles: Mrs G Bach, Professor JH Barker, Mrs IA Fomichev, Mrs L Jongmans, Dr C Nagata, Dr I Nedelcu, Dr MM Porath, Dr A Romano and Dr R Wang.
This work was an investigator-initiated study and partly funded by Guerbet, France. Guerbet is the manufacturer of Lipiodol® Ultra Fluid. The funders had no influence in the study design, data collection, the analyses performed or the interpretation of the study data.
PY - 2021/3/23
Y1 - 2021/3/23
N2 - Recent meta-analyses have shown that a hysterosalpingography (HSG) with oil-based contrast increases pregnancy rates in subfertile women. However, the frequency of complications during or after an HSG with oil-based contrast in subfertile women and/or their offspring is still unclear. This systematic review and meta-analysis, without restrictions on language, publication date or study design, was performed to fill this knowledge gap. The results show that the most frequently reported complication was intravasation of contrast, which occurred in 2.7% with the use of oil-based contrast (31 cohort studies and randomized controlled trials [RCT], 95% CI 1.7–3.8, absolute event rate 664/19,339), compared with 2.0% with the use of water-based contrast (8 cohort studies and RCT, 95% CI 1.2–3.0, absolute event rate 18/1006). In the cohort studies and RCT there were 18 women with an oil embolism (18/19,339 HSG), all without serious lasting consequences. Four cases with serious consequences of an oil embolism were described (retinal oil embolism [n = 1] and cerebral complaints [n = 3]); these reports did not describe the use of adequate fluoroscopy guidance during HSG. In conclusion, the most frequently reported complication after an HSG with oil-based contrast is intravasation occurring in 2.7%. In total four cases with serious consequences of oil embolisms in subfertile women were published.
AB - Recent meta-analyses have shown that a hysterosalpingography (HSG) with oil-based contrast increases pregnancy rates in subfertile women. However, the frequency of complications during or after an HSG with oil-based contrast in subfertile women and/or their offspring is still unclear. This systematic review and meta-analysis, without restrictions on language, publication date or study design, was performed to fill this knowledge gap. The results show that the most frequently reported complication was intravasation of contrast, which occurred in 2.7% with the use of oil-based contrast (31 cohort studies and randomized controlled trials [RCT], 95% CI 1.7–3.8, absolute event rate 664/19,339), compared with 2.0% with the use of water-based contrast (8 cohort studies and RCT, 95% CI 1.2–3.0, absolute event rate 18/1006). In the cohort studies and RCT there were 18 women with an oil embolism (18/19,339 HSG), all without serious lasting consequences. Four cases with serious consequences of an oil embolism were described (retinal oil embolism [n = 1] and cerebral complaints [n = 3]); these reports did not describe the use of adequate fluoroscopy guidance during HSG. In conclusion, the most frequently reported complication after an HSG with oil-based contrast is intravasation occurring in 2.7%. In total four cases with serious consequences of oil embolisms in subfertile women were published.
KW - Complications
KW - Hysterosalpingography
KW - Intravasation
KW - Oil-based contrast
KW - Subfertility
U2 - 10.1016/j.rbmo.2021.03.014
DO - 10.1016/j.rbmo.2021.03.014
M3 - Article
VL - 42
SP - 1119
EP - 1129
JO - Reproductive Biomedicine Online
JF - Reproductive Biomedicine Online
SN - 1472-6483
IS - 6
ER -