Successful Medical Management of Post-hysteroscopic Metroplasty Bleeding with Intravenous Estrogen Therapy: A Report of Two Cases and Review of the Literature

Complications from hysteroscopy are rare, but some are potentially life-threatening. Hemorrhage is one of the most common complications of hysteroscopy. In this study, we report 2 cases of post-hysteroscopic bleeding successfully treated with intravenous conjugated equine estrogen (CEE). In our case report, 2 women who were evaluated for infertility were diagnosed with intrauterine septum. After surgical resection of the septum, significant late post-hysteroscopic bleeding was seen in the fourth and eighteenth day of surgery, respectively. Both patients were successfully treated with intravenous CEE 25 mg in normal saline solution 50 mL given over 20 minutes every 6 hours. These 2 cases illustrate that intravenous CEE therapy as a short-term treatment is relatively safe and can be considered as an alternative in the treatment of severe post-hysteroscopy bleeding in selected patients without risk factors. In patients with risk factors, such as previous thromboembolic disease, alternative modalities of treatment should be considered.