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The fluid consists of cervical and endometrial mucus or in rare instances urine accumulated through a vesicovaginal fistula proximal to the obstruction. In some cases, it is associated with Bardet-Biedl Syndrome. [1] If it occurs in prepubertal girls, it may show up as abdominal swelling. It may be detected by using ultrasound.
Additionally, hematometra may develop as a complication of uterine or cervical surgery such as endometrial ablation, where scar tissue in the endometrium can "wall off" sections of endometrial glands and stroma causing blood to accumulate in the uterine cavity. [1] It can also develop after abortion, [4] as well as after childbirth.
The cervical canal is generally lined by "endocervical mucosa" which consists of a single layer of mucinous columnar epithelium. However, after menopause, the functional squamocolumnar junction moves into the cervical canal, and hence the distal part of the cervical canal may be lined by stratified squamous epithelium (conforming to a "type 3 transformation zone").
Occasionally, Vulsellum forceps may be used to hold the cervical lips open. If cervical weakness is suspected, the catheter should be left inside the lower cervical canal. [ 3 ] Air bubbles should be expelled from the syringe and the catheter, otherwise it will cause confusion of interpretations on HSG.
Cervical canal widening can be temporarily achieved by the insertion of dilators into the cervix. If the stenosis is caused by scar tissue, a laser treatment can be used to vaporize the scarring. [5] Finally, the surgical enlargement of the cervical canal can be performed by hysteroscopic shaving of the cervical tissue. [6]
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The cervical mucus plug (CMP) has a viscoelastic structure which is a gel like. The CMP occupies the cervical canal during pregnancy. It displays potent antimicrobial properties against bacteria such as Staphylococcus saprophyticus, S. aureus, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pyogenes, and S. agalactiae.
The malformation contains large cyst-like cavities containing lymph, a watery fluid that circulates throughout the lymphatic system. Microscopically, cystic hygroma consists of multiple locules filled with lymph. Deep locules are quite big, but they decrease in size towards the surface. Cystic hygromas are benign, but can be disfiguring. It is ...