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Hematometra after thermal balloon endometrial ablation in a patient with cervical incompetence
S R Hubert1, P S Marcus, J M Rothenberg
1Department of Obstetrics and Gynecology, University of Indiana School of Medicine, Indianapolis, USA.
Background:
Thermal balloon endometrial ablation is a relatively safe nonsurgical treatment for menorrhagia. Hematometra follows this procedure in <3 % of patients, but risk factors for this complication are unclear.
Case:
A woman with a history of cervical incompetence during pregnancy later developed cervical occlusion and hematometra after thermal balloon endometrial ablation. Cervical occlusion did not recur after cervical dilatation and temporary placement of a catheter as a stent.
Conclusion:
The normal resistance of the internal cervical os may be an important factor in avoiding thermal damage to the cervix during thermal balloon endometrial ablation. This case suggests that a history of cervical incompetence may be a clinical indicator of decreased cervical resistance.
