Document Detail

Biochemical hemodynamic and hematological changes during transcervical resection of the endometrium using 1.5% glycine as the irrigating solution.
MedLine Citation:
PMID:  9758269     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study fluid absorption during transcervical resection of the endometrium (TCRE) and its effect on the biochemical, hemodynamic and hematological alterations so that life threatening complications of fluid overload may be prevented. METHOD: Intraoperative fluid (1.5% glycine) absorption in 46 women undergoing TCRE was studied and correlated using biochemical parameters (serum sodium, potassium, total proteins, creatinine and blood urea), hemodynamic parameters (pulse rate, blood pressure, oxygen saturation and end tidal CO2) and hematological parameters. Twenty five of these patients had received danazol (800 mg/day) for six weeks prior to TCRE. RESULT: The mean glycine deficit during TCRE was found to be 474.45 ml, with a mean total inflow of 3802.17 ml. Amongst all of the parameters, only serum sodium levels were found to be significantly inversely correlated with the glycine deficit. No case of hyponatremia occurred below a deficit of 1000 ml. Severe hyponatremia was reported in three cases (6.4%) and all three had a glycine deficit of more than 1000 ml. No case of pulmonary edema was noted. The mean glycine deficit was significantly lower (P=0.007) and the duration of procedure significantly shorter (P=0.0009) in the patients who had received danazol. None of the patients in the danazol group had fluid absorption of more than 1000 ml. CONCLUSION: Close monitoring of fluid inflow and outflow should be done during TCRE. Above a deficit of 1000 ml, serum sodium should be measured to detect significant hyponatremia. The use of danazol for endometrial preparation also reduces the mean amount of fluid absorbed.
A Kriplani; J Nath; D Takkar; Maya; H L Kaul
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  80     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-12-03     Completed Date:  1998-12-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  99-104     Citation Subset:  IM    
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi.
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MeSH Terms
Blood Proteins / metabolism
Cervix Uteri*
Creatinine / blood
Endometrium / surgery*
Hemoglobins / metabolism
Irrigation / adverse effects*
Menorrhagia / blood,  physiopathology,  surgery*
Potassium / blood
Sodium / blood
Urea / blood
Water-Electrolyte Imbalance / diagnosis*,  etiology
Reg. No./Substance:
0/Blood Proteins; 0/Hemoglobins; 0/Solutions; 56-40-6/Glycine; 57-13-6/Urea; 60-27-5/Creatinine; 7440-09-7/Potassium; 7440-23-5/Sodium

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