Published On: 05 Sep, 2024 1:08 PM | Updated On: 15 Jan, 2025 8:27 PM
Hysteroscopic removal or ultrasound-guided electric vacuum aspiration of retained products of conception to improve Reproductive and obstetrical outcomes?
Curettage has been widely performed for removing retained products of conception. However, hysteroscopic removal is used as an alternative because of the potentially lower risk of intrauterine adhesions and higher rates of complete removal.
A recent study assessed reproductive and obstetrical outcomes in women desiring to conceive after the removal of retained products of conception by hysteroscopy or ultrasound-guided electric vacuum aspiration. It found:
- Presentation of 261 patients after removal of retained products of conception, comprising 171 women after hysteroscopic removal and 90 women after removal by ultrasound-guided vacuum aspiration.
- 53.8% in the hysteroscopic removal group and 62.2% in the electric vacuum aspiration group desired to conceive.
- Subsequent pregnancy rates were 96.7% after hysteroscopic removal and 92.9% after electric vacuum aspiration.
- The live birth rates were 76.3% and 77.1% after hysteroscopic removal and electric vacuum aspiration, respectively.
- The median time to conception was 8.2 weeks and 6.9 weeks in the hysteroscopic removal group and electric vacuum aspiration group, respectively.
- The overall placental complication rate was 16.3% and 22.9% in the hysteroscopic removal group and the electric vacuum aspiration group, respectively.
Hence, both Hysteroscopic removal and ultrasound-guided electric vacuum aspiration of retained products of conception have a similar effect on subsequent live birth rate, pregnancy rate, time to conception, or pregnancy complications. Reproductive and obstetrical outcomes after removal of retained products of conception are reassuring, albeit with a high risk of placental complications. Reproductive and obstetrical outcomes following the removal of retained products of conception are generally positive, though there remains a significant risk of placental complications.
Wagenaar LP, et al. Reproductive and obstetrical outcomes after treatment of retained products of conception: hysteroscopic removal vs ultrasound-guided electric vacuum aspiration, a prospective follow-up study. American Journal of Obstetrics & Gynecology. 2024;231(2):233.e1 - 233.e8
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