Hysteroscopic Approach and Follow-up Results in Cases with Placenta Retention

Abstract

Objective Evaluation of hysteroscopic approach, findings and subsequent pregnancy follow-ups in cases of placental retention. Methods Between 2015 and 2021, 19 female patients who were referred to our clinic due to placental retention underwent hysteroscopic diagnosis and resection with bipolar cautery. Obstetric histories, preoperative and intraoperative findings of the cases and pregnancy outcomes were followed up. Results The mean age of the cases was 31.7 ±5.4 years. Gravida was 2.7 ±1.4, five (26.5%) of the cases had a history of recurrent miscarriage. Two or more therapeutic curettage procedures were performed in 17 of the cases (89.6%) in the cases before referral, 11 (52.6%) had bleeding complaints and 10 (52.6%) had anemia. During the hysteroscopic intervention, uterine anomaly was found in 7 (36.8%) cases and intrauterine synechiae were found in three cases (15.8%). After hysteroscopy during follow-up intrauterine synechia was observed in three (15.8%) cases and thin endometrium was observed in four (21.1%) cases. in the postoperative 15.2±11 months follow-up period infertility was observed in four cases. The follow-up pregnancy rate was 68.7% and take home baby rate was 56% in this study. Conclusion In cases of failed removal of conception material despite repeated endometrial aspiration, hysteroscopic approach is an effective one step diagnostik and treat option for removal of conceptus material and correction of accompanying pathologies.