Operative hysteroscopy intravascular absorption syndrome: A case report

Abstract

Operative Hysteroscopy Intravascular Absorption (OHIA) syndrome is a rare complication of hysteroscopy. Even under a standard practice, the complication occurs from time to time. The clinical presentations include tissue edema, peripheral edema, pulmonary edema, and brain edema, as well as severe electrolyte imbalance and fluid disturbance. We presented a case of a 47-year-old female who underwent hysteroscopy with total normal saline fluid irrigation of 10,000 ml and developed severe respiratory distress intraoperatively. OHIA is not only a simple condition of hypervolemia from irrigation, but the natural history of the syndrome was presumed to be a two-phase phenomenon of volume overload and fluid leakage. Treatment of the syndrome should be adjusted according to the patient's hemodynamics. Several factors of procedure technique can be adjusted to reduce OHIA risk, including type and amount of uterine distension media, etc. The essentials are awareness of the condition, hemodynamic adjustment and prompt initiation of management.