Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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Hysteroscopic removal of retained products of conception in the outpatient setting*

Keywords:

Retained products of conception, hysteroscopy, intrauterine adhesions, hysteroscopic tissue removal system, reroductive outcomes.

https://doi.org/10.52054/FVVO.15.M.093

N. Smorgick1, Y. Melcer1, O. Levinsohn-Tavor1, S. Haimovich2

1 Department of Obstetrics and Gynecology; The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
2 Department of Obstetrics and Gynecology, Laniado University Hospital, Netanya, Israel. Adelson School of Medicine, Ariel University, Ariel, Israel.

* This article was not peer reviewed by Facts, Views and Vision. The lead author was commissioned by Hologic.

Abstract

This article presents an overview of the diagnosis and classification of retained products of conception (RPOC) as well as removal techniques and discusses the associated complications, advantages and disadvantages of these procedures. RPOC occur when tissue from the placenta or the fetus remain in the uterus after all types of termination of pregnancy and deliveries, including vaginal or cesarean delivery, spontaneous miscarriage, or induced medical or surgical abortion. The diagnosis is based on the combination of clinical findings and ultrasound (US) evaluation (gray-scale and Doppler flow). Hysteroscopy has emerged as the preferred treatment for women with RPOC largely due to its demonstrated safety, feasibility, low incidence of postoperative intrauterine adhesions (IUAs) and high rates of subsequent fertility. Furthermore, thanks to the availability of hysteroscopic tissue removal systems (HTRs) and the miniresectoscope, many hysteroscopic procedures can now be performed without anaesthesia or cervical dilation in an ambulatory setting. Further studies are required to provide a more comprehensive understanding of the reproductive outcomes in patients with pregnancies complicated by RPOC.