Commonly Seen Uterine Abnormalities on Hysterosalpingography (HSG)

Here are a few of the commonly seen abnormalities when we do a hysterosalpingogram (HSG).

To start with, here is a normal HSG

Endometrial polyps are probably the commonest abnormalities seen on HSG. These appear as filling defects and have to be differentiated from air bubbles. If there is any doubt, a hysterosonogram can be done to confirm the diagnosis.

Intrauterine adhesions appear in the form of irregular filling defects. In severe cases, the patient will complain of absent or scant menses. They can cause infertility. After surgery, they can reform and sometimes they can result in the placenta becoming densely attached to the uterine musculature (placenta accreta).

A slight concavity of the uterine fundus is referred to as an "arcuate uterus".

An uterine septum can be associated with miscarriages. It is not possible to differentiate with certainty between an uterine septum and a bicornuate uterus on HSG.

A bicornuate uterus is another commonly seen uterine malformation. It can cause the baby to lie sideways or breech. It is associated with premature delivery.

A unicornuate uterus is another uterine anomaly where only one half of the cavity is present. It cannot be surgically corrected.

A double uterus (uterus didelphys) is sometimes seen. It can be associated with a single or two cervices.

These some of the commonest uterine abnormalities seen on HSG