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Intrauterine pressure and fluid absorption during continuous flow hysteroscopy
S P Vulgaropulos1, L C Haley, J F Hulka
1Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill 27599-7570.
Objectives:
Our objectives were to document the causes of fluid absorption during continuous flow hysteroscopy and to determine under which operative conditions fluid overload may occur.
Study Design:
Fifteen patients underwent operative hysteroscopy with 2% ethanol solution for uterine distention. Absorption of fluid was measured by blood alcohol, sodium, osmolarity, and hematocrit. Intrauterine pressures were measured with an obstetric pressure catheter.
Results:
Alcohol absorption was noted in one patient during a myoma resection. Two additional patients, not in the study, had fluid absorption after partial perforations of the uterus. Under normal operative conditions there were no changes in sodium, osmolarity, or hematocrit. Intrauterine pressures ranged from 45 to 75 mm Hg. Experimental pressures of greater than 200 mm Hg were not associated with fluid absorption.
Conclusions:
Intravasation of fluid may occur through open uterine venous channels with extensive resections and under low pressures in the presence of unrecognized perforations.