Improving hysterosalpingogram confirmatory test follow-up after Essure hysteroscopic sterilization☆
Received 20 August 2009; received in revised form 19 January 2010; accepted 25 January 2010. published online 08 March 2010.
Abstract
Background
Given the need for a 90-day post-Essure hysterosalpingogram (HSG) to confirm proper tubal placement and occlusion, we examined the impact of dedicating a staff nurse to schedule HSG appointments, call with appointment reminders and track HSG compliance for patients who had Essure.
Study Design
We performed a retrospective chart review for patients who underwent Essure sterilization between October 2003 and January 2009. We compared rates of HSG compliance and confirmed tubal occlusion for patients before February 2008 with rates after the protocol change occurred.
Results
Seventy-eight percent of preintervention patients were compliant with at least one HSG following Essure placement compared to 90.9% in the post-intervention group (p value=.033). Tubal occlusion was confirmed by postprocedure HSGs for 123/173 patients (71.1%) in the preintervention group and 48/55 patients (87.3%) in the postintervention group. Patients followed by our staff after our protocol change were more likely to undergo post-Essure compliance (Odds ratio= 2.7, confidence interval = 1.2–7.1, p=.01).
Conclusion
Dedicating a staff nurse to track patients' HSG follow-up as a multicheck system resulted in an improvement in HSG compliance and rates of confirmed tubal placement and occlusion.
aDivision of Family Planning, Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA
bDepartment of Obstetrics and Gynecology, Northwestern University, Chicago, IL 60611, USA
cLoyola University Chicago, Stritch School of Medicine, Maywood, IL 60153, USA
dLoyola University Medical Center, Department of Obstetrics and Gynecology, Maywood, IL 60611, USA
eWomen's Center for Health, Edward Hospital, Naperville, IL 60540, USA
Corresponding author. Presbyterian Hospital PH-69, New York NY 10032, USA. Fax: +1 212 305 6438.
☆ An abstract regarding data on the preintervention group was presented at the 37th Global Congress of the AAGL, October 28–November 1, 2008. The above abstract has been accepted for a poster presentation at the 58th annual American College of Obstetricians and Gynecologists annual clinical meeting in San Francisco May 15–19, 2010.
ABSTRACT