of tubal occlusion in women with infertility, analysing studies that used laparoscopic tubal chromoperturbation dye test as the reference standard. Methods: Studies assessing 2D and 3D/4D HyCoSy for the assessment of tubal occlusion in women with infertility from January 1990 to April 2019 were searched using Medline and Web of Science databases by three authors, using the terms: ''hysterosalpingocontrast-sonography'', ''sonohysterosalpingography'', ''HyCoSy'', ''HyFoSy'', ''three-dimensional'', ''four-dimensional'', ''ultrasound'', ''tubal patency'' and ''tubal occlusion''. Quality was assessed using QUADAS-2 tool. Results: 30 articles were included: 21 studies used 2D HyCoSy to assess tubal occlusion, six used 3D/4D HyCoSy, one study used both techniques but in different set of patients and two used both techniques in the same patients. The risk of bias for most studies was low as assessed in QUADAS-2, except for patient selection domain. Overall, pooled estimated sensitivity and specificity of 2D HyCosy were 86% (95% CI = 80%-91%) and 94% (95% CI = 90%-96%), respectively. These figures were 95% (95% CI = 89%-98%) and 89% (95% CI = 82%-94%) for 3D/4D HyCoSy. High heterogeneity was found for both sensitivity and for specificity among studies. No statistical differences were found between methods (p = 0.13). Conclusions: We concluded that 2D HyCoSy has a similar diagnostic performance than 3D/4D HyCoSy. VP64.07 Is I-shaped uterus more common in patients with hyperandrogenism?
Virtual poster abstracts with abdominal pain, distension and shortness of breath. Observations were normal. A bedside transabdominal ultrasound scan (TAS) revealed individual ovarian volumes of 14cm 3 with gross abdominal ascites. Blood results were also in keeping with severe OHSS. Ultrasound guided paracentesis was performed and thromboprophylaxis commenced. Within 24 hours the patient was in extremis. A bedside TAS showed insufficient ascites to splint the diaphragm and account for the patient's condition. Moments later the patient sustained a cardiorespiratory arrest. The arrest team anesthetist used the same ultrasound machine to demonstrate right-sided heart strain, supporting the suspicion of a pulmonary embolism (PE). Thrombolysis was administered. The patient suffered four further cardiac arrests and was transferred to the Intensive Treatment Unit for extra corporeal membrane oxygenation (ECMO). CT pulmonary angiogram confirmed a massive PE. 10 days later the patient was discharged from hospital with no physical sequelae. Conclusions: This patient suffered a recognised complication of severe OHSS: venous thromboembolism. Rapid access to abdominal scanning ensured that time was not wasted attributing her symptoms simply to ascites. On the spot cardiac scanning gave the confidence to immediately administer lifesaving thrombolysis. Our case supports the importance of access to and training in the use of portable ultrasound across multiple specialties.
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