BLEEDING DURING AND AFTER HYSTEROSCOPY

Objective. To reveal the rate of intraoperative and postoperative bleeding (IPB) in patients with intrauterine abnormalities (IA) during and after diagnostic and operative hysteroscopy and to improve methods for its treatment and prevention. Subject and methods. The rate of IPB due to diagnostic and operative hysteroscopy was examined in 2200 patients with IA. The results of the diagnostic and operative hysteroscopies carried out at two gynecology units, S.P. Botkin City Clinical Hospital, in 2011 to 2012 were studied by the Innovation Department of Mini-Invasive Technologies, V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation. The findings were processed using a package of Statistica programs for Windows 6.0 Stat-Soft. Results. Our investigations indicated that the rate of IPB in patients with IA during and after hysteroscopy was 0.5% (11 patients). Bleeding was rarely observed in the early postoperative period. Bloody discharge, as such, after dissection of the intrauterine septum or resection of the myomatous nodule or endometrium is comparable with moderate menstrual hemorrhage that progressively reduced and ceased for 2-5 days. Conclusion. Drug-induced IPB arrest provides the administration of uterotonic (oxytocin, methylergometrine) and uterotonic and vasopressor (remestip) agents. Bleeding from the cervix uteri can be stopped by ligation of the descending (cervical) branches of the a. uterinae or by vaginal tight tamponade that changes the position of the cervix uteri. To prevent damage to large vessels, it is necessary to exercise particular discretion to use cutting tools in the tubal angles, lateral walls of the uterus and its isthmus.

intraoperative and postoperative bleeding, intrauterine abnormalities