Electrolytes disturbance during hysteroscopy: Case report

Complications may occur in operative hysteroscopy after using distention solution. These complications are different according to type of solution, severity and velocity of absorption. We report a 45-year-old female with fluid overload complication after absorption of Glycine 1.5% during hysteroscopy. The patient underwent operative hysteroscopy for myomectomy. She developed hyponatremia, hypocalcemia and hypokalemia as well as ventricular tachycardia. Serial laboratory tests for serum electrolytes and assessment of atrial blood gases (ABG) were performed. Serum sodium, potassium and calcium levels were 118, 2.9 and 5.5 mmol/L, respectively. Finally, furosemide, amiodarone and calcium chloride were administered and cardio-pulmonary resuscitation (CPR) was done. Successful management of this complication depends on early diagnosis and prompt treatment. The best protocol for preventing this complication is arrangement of equipment for accurate fluid monitoring of intake/output volume of distension solution.