[Air embolism and exploratory hysteroscopy: myths or realities? Preliminary results].
OBJECTIVE
Authors tried to evaluate the prevalence of air embolism which is a severe complication of carbon dioxide hysteroscopy.


METHODS
On one hand, a retrospective inquiry with 18 hyperbaric oxygen therapy units over a 8 year period (1985 to 1992 included); and on the other hand, a prospective study with monthly survey to 84 public Gynaecology units during a 2 year period (January 1991 the 1st to December 1992 the 31st).


RESULTS
From the 18 hyperbaric oxygen therapy units receiving iatrogenic air embolism, gynaecologic endoscopy represent 20% of the patients. Among these, 2/3 come from laparoscopy and 1/3 from hysteroscopy. In the prospective study, 42 public Gynaecology units made 5,140 carbon dioxide hysteroscopies. Three air embolism were declared in this population (i.e. 0.58/1000) with 1 death and 2 recoveries without sequelae after hyperbaric oxygen therapy.


CONCLUSIONS
Analysis of these cases suggest that, for this risk, one should oppose ambulatory hysteroscopy without anaesthesia to hysteroscopy under general anaesthesia with frequent cervical dilatation, prolonged duration and different underlying pathology.
Pierre
F
F
Département de Gynécologie-Obstétrique, CHU de Tours.
Lansac
J
J
Soutoul
J H
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide; D004618:Embolism, Air / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005602:France / Q000453:epidemiology; D006801:Humans; D006931:Hyperbaric Oxygenation; D015907:Hysteroscopy / Q000009:adverse effects*; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects; D011159:Population Surveillance; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies
D002245:Carbon Dioxide
Embolie gazeuse et hystéroscopie exploratoire: mythes ou réalités? Note préliminaire.