Purpose. To demonstrate the possibility of ultrasound diagnostics of endocervical synechia using the echohysterosalpingography method.

Materials and methods. A clinical observation of a patient with chronic cervicitis and primary infertility is presented. Echohysterosalpingography revealed endocervical synechia. Installation of a catheter for echohysterosalpingography was performed at a low level, 1.0 cm above the external os of the cervical canal, without balloon expansion.

Results. Patient T., born in 1985 applied for echohysterosalpingography to assess the patency of the fallopian tubes. Complaints about periodic painful long and scanty menstruation, no pregnancy within 12 months. Observed by a gynecologist since 2016. Ultrasound studies have repeatedly noted the accumulation of fluid in the cavity of the cervical canal, a decrease in the thickness of the endometrium. In 2019, he was diagnosed with inflammatory disease of the cervix. Treatment with anti-inflammatory and anti-adhesion drugs was prescribed. Within a year, pregnancy did not occur and it was decided to perform echohysterosalpingography. When performing echohysterosalpingography, technical difficulties arose in installing a balloon catheter. The catheter was inserted into the lower third of the cervical canal; balloon expansion was not performed due to the patient's pain syndrome. When installing the fluid, a local dilatation of the cervical canal with accumulation of contrast fluid was noted, against the background of which endocervical synechia was visualized. With the introduction of the second portion of fluid, the uterine cavity is without pathology. Free liquid is visualized in the posterior space in 3-5 minutes from the beginning of the installation. Thus, during echohysterosalpingography the diagnosis was made: endocervical synechiae.

Conclusion. If endocervical synechiae is suspected, it is advisable to use a low level of catheter placement without balloon expansion, which can shield endocervical pathology. If it is impossible to adequately assess the cervical canal, recommend cervicoscopy. As a result of this approach, it was possible to visualize endocervical synechia, remove it in a timely manner, and restore menstrual function. The patient was referred to a gynecologist for pregnancy planning.