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LOWER ABDOMINAL SURGERIES AMONG WOMEN WITH INFERTILITY: HSG IMAGING FINDINGS
Onuh A.C., Udobi S.I.* and Udobi J.I.
Objective: To ascertain the various lower abdominal surgeries undergone by women with infertility prior to referral for HSG and document the various uterine and tubal abnormalities detected during the HSG procedure. Methodology: This is a prospective and analytical study of 157 women referred for hysterosalpingography on account of infertility. History of previous lower abdominal surgeries were obtained. Both ethical clearance and informed consent were obtained prior to the study. Analysis was with simple frequency, measures of central tendency and dispersions, and crosstabulation; using the Statistical Package for Social Sciences. Result: A total of 157 had positive history of lower abdominal surgery. Out of this total, 155 (98.7%) were able to identify clearly the surgery they underwent, while 2(1.3%) were not. Within the various subgroups of patients with single lower abdominal surgery only, intrauterine adhesions occurred most frequently among patients with CS 4(50%), followed by myomectomy 2(28.6%) and D&C 2(7.7%); while tubal abnormalities occurred in highest frequency among those with history of laparotomy 3(75%), D&C 15(57.7%), myomectomy 3(42.9%), appendicectomy 6(40.0%), and CS 3(37.5%). Among those with multiple surgeries, intrauterine adhesions occurred commonest among patients with D&C, myomectomy and CS 1(100%), CS and appendicectomy 1(50%), D&C and CS 3(21.4%), while tubal abnormalities occurred more frequently among those with myomectomy and laparotomy 1(100%), D&C and myomectomy 7(77.8%), multiple D&C 22(59.5%), D&C and appendicectomy 11(57.9%). Conclusion: The patients were commonly aware of the lower abdominal surgeries undergone. Intrauterine and tubal pathologies were common among infertile women with lower abdominal surgery, hence special attention should be paid to the medical and surgical management of women of child bearing age.[Full Text Article]