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Archives of Gynecology and Obstetrics

, Volume 288, Issue 5, pp 1035–1038 | Cite as

Does immediate postpartum curettage of the endometrium accelerate recovery from preeclampsia–eclampsia? A randomized controlled trial

  • A. Ragab
  • H. Goda
  • M. Raghib
  • R. Barakat
  • A. El-Samanoudy
  • A. BadawyEmail author
Maternal-Fetal Medicine

Abstract

Objectives

To evaluate the effect of immediate postpartum curettage on rapid resolution of clinical and laboratory indices in pre-eclampsia and eclampsia women.

Methods

A randomized controlled study, comprised of 420 pre-eclamptic or eclamptic women with singleton pregnancy 24 weeks gestation and more. Patients were divided into two groups: 220 patients underwent immediate postpartum curettage and 200 patients as a control group.

Results

The clinical and laboratory prenatal parameters showed no statistical significant differences between both groups. The follow-up for the postnatal clinical and laboratory data showed significant improvement for the mean arterial blood pressure in the curettage group over 6, 12, and 24 h after delivery and significant improvement in the platelet count as well. The average time required for MAP to reach 105 mmHg or less was significantly shorter (P < 0.05) in the curettage group (40 ± 3.15 h) than the control group (86 ± 5.34 h). Two patients in the curettage group developed convulsions versus 11 patients in the control group within the first 24 h after delivery. No maternal mortalities were reported in both groups.

Conclusion

Immediate postpartum curettage is a safe and effective procedure and can accelerate recovery from pre-eclampsia or eclampsia.

Keywords

Pre-eclampsia Eclampsia Curettage Postpartum 

Notes

Conflict of interest

None.

References

  1. 1.
    Roberts JM, Pearson G, Cutler J, Lindheimer M (2003) Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy. Hypertension 41:437–445CrossRefPubMedGoogle Scholar
  2. 2.
    Chang J, Elam-Evans LD, Berg CJ, Herndon J, Flowers L, Seed KA (2003) Pregnancy-related mortality surveillance-United States 1991–1999. MMWR Surveill Summ 52(2):1–8PubMedGoogle Scholar
  3. 3.
    Sibai BM, Ewell M, Levine RJ, KlebanoV MA, Esterlitz J, Catalano PM (1997) Risk factors associated with preeclampsia in healthy nulliparous women. The Calcium for Preeclampsia Prevention (CPEP) Study Group. Am J Obstet Gynecol 177:1003–1010CrossRefPubMedGoogle Scholar
  4. 4.
    Bombrys AE, Barton JR, Nowacki EA, Habli M, Pinder L, How H (2008) Expectant management of severe preeclampsia at less than 27 weeks’ gestation: maternal and perinatal outcomes according to gestational age by weeks at onset of expectant management. Am J Obstet Gynecol 199(3):247–252CrossRefPubMedGoogle Scholar
  5. 5.
    Hnat MD, Sibai BM, Caritis S, Hauth J, Lindheimer MD, MacPherson C (2008) Perinatal outcome in women with recurrent preeclampsia compared with women who develop preeclampsia as nulliparas. Am J Obstet Gynecol 186:422–426CrossRefGoogle Scholar
  6. 6.
    Gaugler-Senden IP, Huijssoon AG, Visser W, Steegers EA, de Groot CJ (2006) Maternal and perinatal outcome of preeclampsia with an onset before 24 weeks’ gestation. Audit in a tertiary referral center. Eur J Obstet Gynecol Reprod Biol 128(1–2):216–221CrossRefPubMedGoogle Scholar
  7. 7.
    Jantasing S, Tanawattanacharoen S (2006) Perinatal outcomes in severe preeclamptic women between 24–33 (+6) weeks’ gestation. J Med Assoc Thai 91(1):25–30Google Scholar
  8. 8.
    Sibai BM, Caritis S, Hauth J (2003) National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. What we have learned about preeclampsia. Semin Perinatol 27:239–246CrossRefPubMedGoogle Scholar
  9. 9.
    Duley L (1992) Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America, and Carribean. Br J Obstet Gynaecol 99:547–553CrossRefPubMedGoogle Scholar
  10. 10.
    Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R (2010) Pre-eclampsia. Lancet 376(9741):631–644CrossRefPubMedGoogle Scholar
  11. 11.
    Szarka A, Rigó J Jr, Lázár L, Beko G, Molvarec A (2010) Circulating cytokines, chemokines, and adhesion molecules in normal pregnancy and preeclampsia determined by multiplex suspension array. BMC Immunol 11:59CrossRefPubMedGoogle Scholar
  12. 12.
    Molvarec A, Szarka A, Walentin S, Szucs E, Nagy B, Rigó J Jr (2010) Circulating angiogenic factors determined by electrochemiluminescence immunoassay in relation to the clinical features and laboratory parameters in women with pre-eclampsia. Hypertens Res 33(9):892–898CrossRefPubMedGoogle Scholar
  13. 13.
    Hunter CA, Howard WF (1960) A pressor substance (hysterotonin) occurring in toxemia. Am J Obstet Gynecol 79:838–846PubMedGoogle Scholar
  14. 14.
    Pritchard JA, MacDonald PC, Gant NF (1985) Williams obstetrics, 17th edn. Appleton Century Crofts, Norwalk, pp 525–560Google Scholar
  15. 15.
    Hunter CA, Howard WF, McCormick CO (1961) Amelioration of the hypertension of toxemia by postpartum curettage. Am J Obstet Gynecol 81:884–889PubMedGoogle Scholar
  16. 16.
    Everett F, Magann EF, Martin JN (1995) New onset hypertension in the pregnant patient. Obstet Gynecol Clin North Am 22:157–172Google Scholar
  17. 17.
    Chandra M, Bhardwaj B (1998) Our experience with use of magnesium sulfate in eclampsia. J Obstet Gynecol India 48:38–42Google Scholar
  18. 18.
    Fejgin MD, Charles AG (1993) Immediate postpartum curettage: accelerated recovery from severe preeclampsia. Obstet Gynecol 82(1):163–164PubMedGoogle Scholar
  19. 19.
    Alkan A, Tugrul S, Oral O, Uslu H, Köse D, Catakli FT (2006) Effects of postpartum uterine curettage on maternal well-being in severe preeclamptic patients. Clin Exp Obstet Gynecol 33(1):55–58PubMedGoogle Scholar
  20. 20.
    Magann EF, Martin JN, Isaacs JP et al (1993) Immediate postpartum curettage: accelerated recovery from severe preeclampsia. Obstet Gynecol 81:502–506PubMedGoogle Scholar
  21. 21.
    Witlin AG, Sadde GR, Mattar F et al (1999) Risk factors for abruption placentae and eclampsia: analysis of 445 consecutively managed women with severe preeclampsia and eclampsia. Am J Obstet Gynecol 180:1322–1329CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • A. Ragab
    • 1
  • H. Goda
    • 1
  • M. Raghib
    • 1
  • R. Barakat
    • 1
  • A. El-Samanoudy
    • 2
  • A. Badawy
    • 1
    Email author
  1. 1.Department of Obstetrics/GynecologyMansoura University HospitalsMansouraEgypt
  2. 2.Department of BiochemistryMansoura Faculty of MedicineMansouraEgypt

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