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Routine ultrasonographic and hysteroscopic evaluations of women undergoing postpartum manual removal of placenta: a retrospective cohort study

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Abstract

Purpose

This study aimed to assess the rates of retained products of conception (RPOC) after routine postpartum evaluation of patients who underwent post-delivery manual uterine revision due to retained placenta.

Methods

This is a retrospective cohort study of 599 consecutive women who underwent manual removal of placenta during 2010–2018. Group A comprised 465 women who underwent postpartum symptom-based evaluation (2010–2016). Group B comprised 134 women who were routinely evaluated by ultrasound and subsequently by hysteroscopic examination 6 weeks after delivery (2016–2018).

Results

The rates of abnormal postpartum bleeding were similar between groups A and B (12% and 13%, respectively, p = 0.72%). A significantly smaller proportion of women underwent hysteroscopy in group A than group B (12% vs. 37%, p < 0.05). The rate of persistent RPOC confirmed by hysteroscopy was significantly lower in group A than group B (9.7% vs. 23%, p < 0.05).

Conclusion

Among patients who underwent post-delivery manual removal of placenta, a threefold higher rate of RPOC was discovered by routine elective evaluation than by evaluating only symptomatic patients. Future studies may show whether this approach translates to an effect on fertility.

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Author information

AN: manuscript writing–editing, data analyzing; NE: data collection, data analyzing; EI: data collection; EZ: data analyzing; SS: data analyzing; VK: data analyzing; EYA: manuscript editing, supervsior; OG: Supervisor, project administration, manuscript editing.

Correspondence to Ahmet Namazov.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

The study was designed as a retrospective study. All data was collected anonymously. The Ethical board waived informed consent.

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Namazov, A., Elkabetz, N., Ivshin, E. et al. Routine ultrasonographic and hysteroscopic evaluations of women undergoing postpartum manual removal of placenta: a retrospective cohort study. Arch Gynecol Obstet (2020) doi:10.1007/s00404-020-05433-5

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Keywords

  • Retained products of conception (RPOC)
  • Manual removal
  • Placenta
  • Hysteroscopy
  • Ultrasound