title: Retained Products of Conception Associated with Intravasation of Hysterosalpingogram Contrast and Hysteroscopic Distention Media: A Case Report.
abstract: BACKGROUND
  Hysteroscopic resection of retained products of conception has not been previously described to increase the risk for volume overload at the time of hysteroscopy.
  
  
  METHODS
  A 35-year-old woman with a history of recurrent pregnancy loss was evaluated by a hysterosalpingogram that identified retained products of conception with adjacent contrast intravasation. She underwent a hysteroscopic resection of the uterine septum and products of conception. During the 15 minute operating time she developed a fluid deficit of 2,300 cc of 3% sorbitol with resulting hyponatremia despite normal pressure and flow settings on the fluid management equipment.
  
  
  CONCLUSIONS
  When a hysterosalpingogram demonstrates likely retained products of conception with an accompanying intravasation of contrast media, the provider should consider this finding a potential risk factor for excess intravasation of hysteroscopic distention media and take additional precautions to avoid volume overload.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Tobler
authors.forename: Sarah
authors.initials: S
authors.lastname: Oman
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kolp
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology; D007047:Hysterosalpingography / Q000009:adverse effects*; D015907:Hysteroscopy / Q000009:adverse effects*; D018457:Placenta, Retained / Q000175:diagnosis / Q000601:surgery; D011247:Pregnancy; D013012:Sorbitol; D014599:Uterus / Q000601:surgery*
chemical_list: D003287:Contrast Media; D013012:Sorbitol