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

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-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.

Original languageEnglish
Pages (from-to)1119-1129
Number of pages11
JournalReproductive Biomedicine Online
Volume42
Issue number6
DOIs
Publication statusPublished - Jun 2021

Keywords

  • Contrast Media/adverse effects
  • Embolism/chemically induced
  • Humans
  • Hysterosalpingography
  • Iodized Oil/adverse effects
  • Thyroid Diseases/chemically induced
  • PULMONARY
  • IODIZED OIL
  • Subfertility
  • ACCIDENTAL INJECTION
  • NEONATES BORN
  • Complications
  • LIPIODOL
  • THYROID-DYSFUNCTION
  • FLUSH TRIAL
  • Intravasation
  • INTRAVASATION
  • SOLUBLE CONTRAST
  • FETAL GOITER
  • Oil-based contrast

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