Open AccessHemorrhage risk during operative hysteroscopy
Author(s) -
Agostini Aubert,
Cravello Ludovic,
Desbrière Raoul,
Maisonneuve Anne Sophie,
Roger Valérie,
Blanc Bernard
Publication year - 2002
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1034/j.1600-0412.2002.810914.x
Subject(s) - medicine , hysteroscopy , surgery , relative risk , endometrial ablation , complication , uterine cavity , hysterectomy , uterus , confidence interval
Background. To evaluate the risk of hemorrhage during hysteroscopic surgery. Methods. Cases of hemorrhage during hysteroscopic surgery were assessed in a single center, observational, prospective study conducted from 1990 to 2000, including 2116 surgical hysteroscopies. Risk of hemorrhage was evaluated according to the hysteroscopic procedure. The management of this complication was also noted. Results. Thirteen cases (0.61%) were reported. In six cases, hemorrhage stopped spontaneously. For six patients, a Foley (no. 10) probe was introduced into the uterine cavity and inflated for 24 h to stop hemorrhage. For one patient, immediately from the start of the procedure, the uterine arteries were ligatured through the vaginal route in order to stop bleeding. Haemorrhage risk was higher during hysteroscopic adhesiolysis compared with endometrial ablation {Relative risk [RR] 5.22 (1.26–21.64); p = 0.02}, polyp [RR 5.3 (1.04–27.09); p = 0.04], and fibroid resections [RR 6.55 (1.58–27.17); p = 0.01]. Haemorrhage risk was however, comparable for endometrial ablation, uterus septa section, polyp, and fibroid resections ( p = 0.92). Conclusions. Hemorrhage risk is higher during synechiolysis compared with other procedures. An inflated Foley probe may be an efficient means of stopping hemorrhage.