Postpartum retained products of conception: Is it possible to avoid postpartum curettage?. Issue 2 (20th April 2021)

• Record Type: Journal Article
• Authors: Nir, Arava; Mor, Matan; Yekutiel, Matar; Eisenberg, Neta; Smorgick, Noam
• Is Part Of: International journal of gynaecology and obstetrics. Volume 156:Issue 2(2022)
• Page Start: 231
• Page End: 235
• Publication Date: 2021-04-20
• Subjects: hysteroscopy -- intrauterine adhesions -- residual trophoblastic tissue -- retained products of conception -- suction curettage; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.13696
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: Removal of retained products of conception (RPOC) by suction curettage or hysteroscopy may be required in the postpartum period, possibly causing intrauterine adhesions. We investigated whether rates of suction curettage, hysteroscopy, and postoperative intrauterine adhesions have changed over time. Methods: Parturients considered at risk for RPOC were followed in a specialized postpartum clinic with sequential ultrasound scans. We compared the rates of women requiring surgical procedures for RPOC removal and rates of postoperative intrauterine adhesions between two 2‐year periods: 2011–2012 ("early period") and 2016–2017 ("late period"). Results: The overall rates of women requiring a surgical procedure for removal of RPOC did not differ between the early and late periods (38/762 [5.0%] vs 41/732 [5.6%], respectively, P = 0.595). However, removal of RPOC by suction curettage decreased significantly over time whereas removal by hysteroscopy increased ( P = 0.022). Intrauterine adhesions were diagnosed in 7 of 38 women (18.4%) who underwent a surgical procedure for RPOC removal in the early period, but none of the patients operated on in the late period developed intrauterine adhesions ( P = 0.004). Conclusion: Removal of RPOC in postpartum women may be completed by hysteroscopy in most cases, significantly reducing the need for postpartum curettage and the rates of postoperative intrauterine adhesions. Abstract : Postpartum retained products of conception may be removed by hysteroscopy in most women, reducing the need for suction curettage and rates of postoperative intrauterine adhesions.