Hysteroscopy: indications and contraindications

 

Hysteroscopy is an endoscopic examination of the uterine cavity, which, today, is an informative method of diagnosis in various diseases of the uterus. The article describes in detail the indications and contraindications for hysteroscopy.

Testimony

So, to start with, in what diseases and pathological conditions conduct research. Testimony to the appointment of endoscopic diagnosis are:

  • Suspicion of pathological processes in endometrium, when other diagnostic methods do not allow to establish an accurate diagnosis.
  • Monitoring the effectiveness of treatment of some gynecological diseases. In this case, the controlled state of the endometrium and other indicators of hormonal influence.
  • Pathological course of pregnancy. In this case, the procedure is carried out only when there is a high risk to life of pregnant woman. Otherwise, the research is strictly prohibited because it can lead to injury of the unborn baby and disruption of membranes.
  • Difficulty in removal of IUDs. The intrauterine device is inserted into the woman’s body for a certain period. If the tool is incorrectly installed or expired replacement period of the spiral, when removing can cause problems. In such cases, it may be used hysteroscopy.

What you can see in the survey?

That allows you to see hysteroscopy and what treatments can be done with it in the uterus?

  • to assess the condition of the mucous membrane;
  • to check the availability and size of the orifices of the fallopian tubes;
  • to diagnose endometrial growths;
  • to diagnose malformations of the body;
  • to establish the presence of residues of the fetus or the amniotic SAC after a medical abortion or miscarriage;
  • to evaluate the effectiveness of hormone therapy for some gynecological problems;
  • confirm the need for surgery;
  • take a piece of tissue for histological examination;
  • to control the process of «scraping» of the uterine cavity to prevent the development of complications.

Despite the universality of the procedure, not all women can be assigned the study.

Contraindications

Contraindications to hysteroscopy are:

  • Physical exhaustion.
  • Severe liver disease and kidney.
  • Chronic diseases of the respiratory system and the cardiovascular system in the stage of decompensation.
  • The degree of purity of the vagina 3-4 degrees.
  • The inflammatory process in the urogenital organs in acute and subacute period.
  • A state of shock.
  • Coma.
  • Of blood clotting.
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In the above cases, the examination is dangerous to women’s health. However, sometimes, the doctor decides on the procedure with safety precautions.

Does hysteroscopy special training?

No matter what the purpose is of the study, the physician definitely makes the training plan of the patient. The standard plan includes a series of events:

  • gynecological tool inspection and manual vaginal examination;
  • laboratory studies of blood, urine, vaginal and urethral swabs;

  • consultation of doctor-therapist;
  • the examination by the anaesthetist with the aim of deciding on the type of anesthesia;
  • x-ray examination of the lungs;
  • electrocardiogram;
  • indication – ultrasound examination of small pelvis organs and colposcopy.

In addition, if necessary, can appoint additional expert advice and the conduct of qualifying research.

Complications

In some cases, the hysteroscopy can lead to complications:

  • Perforation of the uterus. This complication occurs most frequently and is associated with damage to uterine walls with a hysteroscope.
  • Bleeding that develops as a result of damage to the cervix or uterine wall.

  • Hematometra (accumulation of blood). Complication, manifested by pain in the abdomen and disorders of menstruation. A complication is also of traumatic origin.
  • Damage to nearby organs (bowel loops, urinary bladder) of thermal nature.
  • Post anesthetic complications (gas embolism, cardiac arrhythmias, pulmonary edema, respiratory distress syndrome, and others).

When hysteroscopy with consideration of indications and contraindications complications are rare. However, when conducting surgical procedures with the hysteroscope during the first day requires careful monitoring of the patient. If the procedure is performed for diagnostic purposes, a woman on the same day released home.

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