What precautions should be taken before a hysteroscopy?
May 27, 2022
Source: Cainiu Health
Dr. Chen Zhe
Introduction
Hysteroscopy is performed to dilate the cervical canal and visualize the morphology and pathological changes of the cervical canal, uterine cavity, and both fallopian tubes. Prior to the procedure, contraindications must be ruled out—such as acute genital tract inflammation, acute respiratory tract infection, or the acute phase of cardiac, hepatic, or renal failure. If the patient is otherwise unable to tolerate the procedure, the timing of hysteroscopy should be determined on a case-by-case basis.
Direct visualization examination—typically performed during a gynecological exam—allows only a general assessment of the external appearance and size of the uterus, ovaries, vulva, and vagina. It often fails to reveal intrauterine morphology; thus, intrauterine conditions must be assessed indirectly via ultrasound. So, what precautions should be taken before and during hysteroscopy?
Precautions for Hysteroscopy
Hysteroscopy is performed to dilate the cervical canal and uterine cavity to directly visualize the cervical canal, uterine cavity, and both fallopian tube ostia, as well as detect any morphological or pathological abnormalities. Prior to the procedure, contraindications must be ruled out—including acute systemic infections (e.g., acute respiratory tract infection), acute decompensation of cardiac, hepatic, or renal failure, and inability to tolerate surgery. If any of the following contraindications are present, the timing of hysteroscopy should be carefully evaluated: body temperature >37.5°C; severe cervical stenosis or scarring preventing adequate cervical dilation; history of uterine perforation or prior uterine surgery; invasive cervical cancer; or active genital tuberculosis not yet treated with a standardized antitubercular regimen.
During hysteroscopy, the hysteroscope must be completely purged of air before insertion into the uterine cavity to prevent air embolism. Throughout the procedure, irrigation fluid pressure must be strictly controlled to avoid excessive pressure. Careful attention must also be paid to resection depth to prevent uterine perforation.
The procedure should not be prolonged unnecessarily to minimize the risk of hyponatremic (hypo-osmolar) fluid overload syndrome. Postoperatively, timely anti-inflammatory treatment is required. Depending on the findings and procedural complexity, measures to prevent postoperative cervical adhesions may be necessary. We hope this information is helpful to you!
