A 30-year-old gravida 2, para 0011 patient presents with 15 months of secondary infertility. She notes a change in her menstrual pattern with light menstrual bleeding consisting of menstrual spotting for 1 day every 31 days. She reports significant cyclic pain with spotting. She had normal menstrual cycles with four days of flow prior to her last pregnancy two years ago that ended in a miscarriage at nine weeks. She failed medical management of first-trimester loss and underwent a dilation and curettage (D&C) for evacuation of products of conception. The procedure was uneventful; however, she did require a course of antibiotics afterwards for postoperative endometritis. The couple did not report any issues with conceiving their previous pregnancies. She denies any significant past medical or surgical history other than the D&C.

A 55-year-old gravida 1, para 1001 presents to the office with complaints of new-onset vaginal bleeding. She has not had a menstrual period since undergoing an endometrial ablation (EA) seven years ago. The vaginal bleeding started five days ago and is intermittent. She has been bleeding through three to four regular maxi-pads per day. Review of systems is negative for dizziness, fatigue, shortness of breath, and pelvic pain. She is currently sexually active with her husband, who underwent a vasectomy after the birth of their child. Her past medical history is significant for regular, heavy menstrual cycles. She denies a history of bleeding disorders, diabetes, or hypertension. She has no other pertinent surgical history. She has no family history of endometrial cancer. She is not taking any medications and has no drug allergies.

A 33-year-old nulligravid woman is undergoing hysteroscopic removal of a 5 cm FIGO type 1 submucosal myoma due to heavy menstrual bleeding and mild anemia. She is otherwise in good health and has no significant medical or surgical history. She is not on any medications and denies drug allergy. The patient receives general anesthesia without difficulty. The procedure commences with use of a fluid management system and a bipolar resectoscope to remove myoma fragments. Approximately 30 minutes into the surgery, the anesthesiologist becomes concerned due to sudden decrease of oxygen saturation to 87%. The total fluid deficit is approaching 2300 mL. The anesthesiologist administers intravenous (IV) furosemide and asks the surgeon to terminate the procedure. Several minutes later, oxygen saturations increase to 92%. The patient is awakened from anesthesia and proceeds to the recovery room in a stable condition.