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Uterine preservation surgery for placental polyp
Author(s) -
Hiraki Koichi,
Khan Khaleque Newaz,
Kitajima Michio,
Fujishita Akira,
Masuzaki Hideaki
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12128
Subject(s) - medicine , curettage , myometrium , surgery , magnetic resonance imaging , ultrasound , endometrial polyp , blood flow , laparotomy , uterine cavity , abortion , blood loss , pregnancy , radiology , uterus , hysteroscopy , genetics , biology
Abstract Aim To examine clinical and surgical performances of cases with placental polyps in which uterine preservation surgery was conducted. Methods During the period S eptember 2002 to A pril 2009, we examined eight cases (hysteroscopic resection, six cases; laparotomy, one case; dilatation and curettage, one case) diagnosed with placental polyp that had been treated with polyp extraction surgery. Imaging evaluation was done using magnetic resonance imaging and 2‐ D ultrasound. Results Three of the eight cases (37.5%) had been first‐time pregnancies. Most of our cases experienced minimal surgical manipulation after medical abortion. Among them, six cases (75%) were mid‐term medical abortions, one case (12.5%) received no treatment after spontaneous abortion, and one case (12.5%) had postsurgical abortion (dilatation and curettage). All cases showed variable amount of blood flow in the internal mass and myometrium by color D oppler ultrasound. Magnetic resonance imaging angiography showed contrast effects in the intrauterine cavity and myometrium in selected cases. The average duration from diagnosis to surgery was 32 days (range, 11–105). Color D oppler revealed a reduction in blood flow in five cases during the waiting period until surgery with an average blood loss of 10 g (range, 0–20) during surgery. Conclusion Use of color D oppler ultrasound may be useful in diagnosing placental polyp. Although hysteroscopic resection of placental polyp is effective in patients hoping for uterine preservation, delaying timing of surgery may reduce blood loss during operative procedure.