Serum levels of endometrial proteins during transcervical resection of the endometrium

Robert G. Hahn, Joel Olsson, Katarina Englund, Markku Seppälä
In: BJOG: An International Journal of Obstetrics & Gynaecology · 1996 · vol. 103(5) , pp. 442–445 · doi:10.1111/j.1471-0528.1996.tb09770.x · PMID:8624317 · W2027634080
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This study found that absorption of irrigating fluid during transcervical endometrial resection correlated with increased serum levels of endometrial proteins IGFBP-1 and PP14.

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Abstract

OBJECTIVE: To study the potential for dissemination of endometrial tissue substances during transcervical resection of the endometrium (TCRE). DESIGN: Prospective study. SETTING: One university and two county hospitals. PARTICIPANTS: Forty-eight women with dysfunctional bleeding. INTERVENTIONS: The serum levels of two endometrial proteins, insulin-like growth factor binding protein-1 (IGFBP-1) and placental protein 14 (PP14), were measured before and every 10 min during the operations. Blood loss was also measured by a photometer together with absorption of the irrigating fluid containing glycine 1.5% and ethanol 1% by expired-breath tests, and serum sodium and volumetric fluid balances. MAIN OUTCOME MEASURES: Linear correlations between changes in IGFBP-1 and PP14 during TCRE and operating parameters such as operating time, blood loss and fluid absorption. RESULTS: The baseline levels of IGFBP-1 were normal but PP14 could only be detected in one third of the patients, which was due, in part, to pre-operative treatment with danazol. The highest levels of IGFBP-1 and PP14 during surgery correlated positively with the baseline concentrations. Fluid absorption (median 405 ml, range 0-2177) was the only surgical factor associated with increasing serum levels of endometrial proteins. CONCLUSION: Absorption of the solution used to irrigate the uterus is associated with dissemination of endometrial products in the bloodstream during TCRE.

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