30)OFFICE HYSTEROSCOPY FOR POST TRAUMATIC SYNECHIA скачать в хорошем качестве

30)OFFICE HYSTEROSCOPY FOR POST TRAUMATIC SYNECHIA

One of the common cause of intrauterine Synechia is endometrial trauma. Lscs / D&C are common offenders . In fact after one D&C the incidence is 10%. This can lead to abortions/infertility. It is important to suspect and diagnose these synechia and treat it at the earliest to achieve success in fertility. This video demonstrates that we suspected IUA on routine TVS during follicular study and 3 D USG was able to pick the division of the cavity and even probable stenosis at Internal os. She was posted for office hysteroscopy on the 8th day of periods and the stenosis in upper 1/3rd of cervical canal and int os was dealt by bevel of scope and grasper. Using EASI endomat to regulate irrigation pressure so as to minimise pain felt by the patient. The adhesion band was mapped . The depth and thickness of the adhesion band is well demonstrated . Rt ostium was not seen due to the band. With semi rigid scissors the band was cut in centre. The cuts have to be small and withdraw the scissors after each cut so as to remain in the band. Once the band is cut, the adhesion retracts and rt ostium is visualised in panaromic view. No adhesion barrier is used as it is single band. Patient was put on estradiol valerate 2mg twice a day for 5 days and follicular study continued from 10th day.