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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (4): 472-477    DOI: 10.31083/j.ceog.2020.04.5259
Original Research Previous articles | Next articles
Hysteroscopic removal of retained products of conception with enhanced vascularity: a study of reliability
G. Garuti1, *(), E. Castellacci2, S. Calabrese1, S. Calzolari2
1Obstetrics and Gynecology Department, Public Hospital of Lodi, Lodi, Italy
2Public Hospital Palagi, Florence, Italy
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Abstract  
Purpose of Investigation: Retained products of conception (RPOC) is the leading cause of postpartum or post-abortion hemorrhage. RPOC showing high vascularity at ultrasound assessment (HV-RPOC) showed an enhanced hemorrhagic risk following blind surgical uterine emptying. The authors describe the clinical outcome of patients suffering from HV-RPOC undergoing hysteroscopic removal. Material and Methods: Cohort of symptomatic patients suffering from HV-RPOC following miscarriages, pregnancy terminations, and term deliveries. After ultrasound selection based on color-Doppler showing HV-RPOC, all patients underwent hysteroscopic resection. Results: Twenty-seven patients met the selection criteria. HV-RPOC were found in 14 and six women after first and second trimester pregnancy termination, respectively. In seven women RPOC were found after term delivery. In 18 women (66.6%) RPOC were found firmly adherent to myometrium. Neither intra- nor postoperative complications were recorded. Hysteroscopy follow-up was carried-out in 16 patients. Normal findings were found in 15 women in one case a mild adhesion was observed. Conclusion: HV-RPOC are often characterized by abnormally adherent placenta, suggesting that an accreta can be an underlying etiology. A reliable management can be accomplished by hysteroscopic resection.
Key words:  Abnormally invasive placenta      Retained products of conception      Highly vascularized retained products of conception      Hysteroscopy      Placenta accreta      Post abortion hemorrhage.     
Submitted:  19 May 2019      Accepted:  01 August 2019      Published:  15 August 2020     
*Corresponding Author(s):  GIANCARLO GARUTI     E-mail:  giancarlo.garuti@tiscali.it

Cite this article: 

G. Garuti, E. Castellacci, S. Calabrese, S. Calzolari. Hysteroscopic removal of retained products of conception with enhanced vascularity: a study of reliability. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 472-477.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.04.5259     OR     https://ceog.imrpress.com/EN/Y2020/V47/I4/472

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