Safety of oil-based contrast medium for hysterosalpingography: a systematic review

Inez Roest; Kimmy Rosielle; Nienke van Welie; Kim Dreyer; Marlies Bongers; Velja Mijatovic; Ben W. Mol; Carolien Koks

doi:10.1016/j.rbmo.2021.03.014

Safety of oil-based contrast medium for hysterosalpingography: a systematic review

Inez Roest^* (Corresponding Author), Kimmy Rosielle, Nienke van Welie, Kim Dreyer, Marlies Bongers, Velja Mijatovic, Ben W. Mol, Carolien Koks

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

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.

Original language	English
Pages (from-to)	1119-1129
Number of pages	11
Journal	Reproductive Biomedicine Online
Volume	42
Issue number	6
Early online date	23 Mar 2021
DOIs	https://doi.org/10.1016/j.rbmo.2021.03.014
Publication status	Published - 23 Mar 2021

Bibliographical note

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.

Keywords

Complications
Hysterosalpingography
Intravasation
Oil-based contrast
Subfertility

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Cite this

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title = "Safety of oil-based contrast medium for hysterosalpingography: a systematic review",

abstract = "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.",

keywords = "Complications, Hysterosalpingography, Intravasation, Oil-based contrast, Subfertility",

author = "Inez Roest and Kimmy Rosielle and {van Welie}, Nienke and Kim Dreyer and Marlies Bongers and Velja Mijatovic and Mol, {Ben W.} and Carolien Koks",

note = "Acknowledgements We would like to thank Mr B de Vries, Clinical Librarian at the M{\'a}xima 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{\textregistered} Ultra Fluid. The funders had no influence in the study design, data collection, the analyses performed or the interpretation of the study data. ",

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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

SN - 1472-6483

VL - 42

SP - 1119

EP - 1129

JO - Reproductive Biomedicine Online

JF - Reproductive Biomedicine Online

IS - 6

ER -

Safety of oil-based contrast medium for hysterosalpingography: a systematic review

Abstract

Bibliographical note

Keywords

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Cite this