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A comparison of reproductive outcomes following hysteroscopic management versus dilatation and curettage of retained products of conception
Author(s) -
BenAmi Ido,
Melcer Yaakov,
Smorgick Noam,
Schneider David,
Pansky Moty,
Halperin Reuvit
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.05.003
Subject(s) - medicine , hysteroscopy , products of conception , curettage , infertility , surgery , retrospective cohort study , tubal occlusion , etiology , abortion , pregnancy , population , family planning , research methodology , environmental health , biology , genetics
Objective To compare the reproductive outcome of women who underwent blind dilatation and curettage (D&C) with those who underwent hysteroscopic resection of pathologically confirmed retained products of conception (RPOC). Methods Medical records of women who underwent either D&C or hysteroscopic resection of RPOC at Assaf Harofeh Medical Center, Israel, between 2000 and 2010 were retrospectively reviewed. Results A total of 177 women with pathologically confirmed RPOC underwent either D&C (n = 94, 53.1%) or hysteroscopy (n = 83, 46.9%). Mean time to conception was significantly shorter after hysteroscopy than after D&C (7.4 ± 7 vs 12.9 ± 16.8 months, P = 0.037). Rate of occurrence of a newly diagnosed infertility problem was significantly higher following D&C than hysteroscopy (23 [24.5%] vs 10 [12.0%]; P = 0.034). Etiology of the new problem was mechanical, including tubal occlusion and intrauterine adhesions. Logistic regression comparing both methods revealed that hysteroscopic resection was associated with a significant reduction in the occurrence of a new infertility problem compared with D&C (OR 0.42; 95% CI, 0.18–0.96, P = 0.04). Conclusion Hysteroscopic removal of RPOC is associated with a shorter mean time to further conception and a lower rate of occurrence of newly diagnosed infertility problems than D&C.