Skip to main content
SpringerLink
Log in

Does the time interval between the diagnosis to hysteroscopic evacuation of retained products of conception affect reproductive outcome?

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Retained products of conception (RPOC) refer to the presence of placental and/or fetal tissue in the uterus following delivery, miscarriage, or termination of pregnancy. The presence of such tissue might lead to complications, which might be the culprit of secondary infertility. Although some studies have considered the management of symptomatic RPOC, there are no data regarding the management of asymptomatic, incidentally diagnosed RPOC, nor the optimal time for surgical intervention required to prevent adverse reproductive outcomes.

Objective

This study aimed to examine whether the time interval between the pregnancy termination to surgical evacuation of RPOC influences the reproductive outcome in asymptomatic women.

Design

This is a retrospective cohort study, which includes women who were admitted for an elective procedure in the gynecology day-care clinic due to suspected RPOC. The diagnosis was made during patients’ routine examination following either delivery or miscarriage between the years 2010 and 2018.

Setting

Records of women who were admitted to the day-care gynecology department during the years 2010–2018 for hysteroscopic removal of RPOC.

Patients

The patients were divided into three groups, according to the time from desired pregnancy to conception following the procedure (> 6; 3–6 and < 3 months). Data regarding obstetric history prior to the procedure was retrieved from patients’ clinical files, while data concerning reproductive outcome following the procedure was obtained by telephone questionnaires.

Intervention

Data regarding obstetric history prior to the procedure was retrieved from patients’ clinical files, while data concerning reproductive outcome following the procedure was obtained by telephone questionnaires.

Measurements

75 patients whose reproductive outcome could be analyzed were included in the study. The time interval between the end of pregnancy and surgical intervention was analyzed as a continuous variable and was compared between the three groups, together with parameters such as age and obstetric history.

Results

There were no significant differences between the groups.

Conclusions

The main finding of the present study is that the time interval between the end of pregnancy and surgical evacuation of the asymptomatic, incidentally diagnosed RPOC, has no significant implication on patients’ reproductive outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Romero R, Hsu YC, Athanassiadis AP, Hagay Z, Avila C, Nores J et al (1990) Preterm delivery: a risk for retained placenta. Am J Obstet Gnecol 163:823–825

    Article  CAS  Google Scholar 

  2. van den Bosch T, Daemen A, Van Schoubroeck D, Pochet N, De Moor B, Timmerman D (2008) Occurrence and outcome of residual trophoblastic tissue: a prospective study. J Ultrasound Med 27(3):357–361

    Article  Google Scholar 

  3. Weeks AD (2008) The retained placenta. Best Pract Res Clin Obstet Gynaecol 22(6):1103–1117

    Article  Google Scholar 

  4. Barel O, Krakov A, Pansky M, Vaknin Z, Halperin R, Smorgick N (2015) Intrauterine adhesions after hysteroscopic treatment for retained products of conception: what are the risk factors? Fertil Steril 103(3):775–779

    Article  Google Scholar 

  5. Yu D, Wong YM, Cheong Y, Xia E, Li TC (2008) Asherman syndrome—one century later. Fertil Steril 89(4):759–779

    Article  Google Scholar 

  6. Ben-Ami I, Ofir T, Melcer Y, Smorgick N, Schneider D, Pansky M, Halperin R (2014) Infertility following retained products of conception: is it the surgical procedure or the presence of trophoblastic tissue? Eur J Obstet Gynecol Reprod Biol 182:132–135

    Article  Google Scholar 

  7. Sellmyer MA, Desser TS, Maturen KE, Jeffrey RB Jr, Kamaya A (2013) Physiologic, histologic, and imaging features of retained products of conception. Radiographics 33(3):781–796

    Article  Google Scholar 

  8. Goldenberg M, Schiff E, Achiron R, Lipitz S, Mashiach S (1997) Managing residual trophoblastic tissue Hysteroscopy for directing curettage. J Reprod Med 42(1):26–28

    CAS  PubMed  Google Scholar 

  9. Golan A, Dishi M, Shalev A, Keidar R, Ginath S, Sagiv R (2011) Operative hysteroscopy to remove retained products of conception: novel treatment of an old problem. J Minim Invasive Gynecol 18(1):100–103

    Article  Google Scholar 

  10. Florio P, Filippeschi M, Moncini I, Marra E, Franchini M, Gubbini G (2012) Hysteroscopic treatment of the cesarean-induced isthmocele in restoring infertility. Curr Opin Obstet Gynecol 24(3):180–186

    Article  Google Scholar 

  11. Faivre E, Deffieux X, Mrazguia C, Gervaise A, Chauveaud-Lambling A, Frydman R, Fernandez H (2009) Hysteroscopic management of residual trophoblastic tissue and reproductive outcome: a pilot study. J Minim Invasive Gynecol 16(4):487–490

    Article  Google Scholar 

  12. Ben-Ami I, Melcer Y, Smorgick N, Schneider D, Pansky M, Halperin R (2014) A comparison of reproductive outcomes following hysteroscopic management versus dilatation and curettage of retained products of conception. Int J Gynecol Obstet 127(1):86–89

    Article  Google Scholar 

  13. Smorgick N, Barel O, Fuchs N, Ben-Ami I, Pansky M, Vaknin Z (2014) Hysteroscopic management of retained products of conception: meta-analysis and literature review. Eur J Obstet Gynecol Reprod Biol 173:19–22

    Article  Google Scholar 

  14. Sonnier L, Torre A, Broux P, Fauconnier A, Huchon C (2017) Evaluation of fertility after operative hysteroscopy to remove retained products of conception. Eur J Obstet Gynecol Reprod Biol 211:98–102

    Article  Google Scholar 

  15. Hooker AB, Aydin H, Brölmann HA, Huirne JA (2016) Long-term complications and reproductive outcome after the management of retained products of conception: a systematic review. Fertil Steril 105(1):156–164

    Article  Google Scholar 

Download references

Funding

No external financial support was used for this research.

Author information

Author notes

  1. Michal Tarasov and Yechiel Z. Burke authors are equally contribution to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel

    Yechiel Z. Burke, David Stockheim, Raoul Orvieto & Shlomo B. Cohen

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Michal Tarasov, Raoul Orvieto & Shlomo B. Cohen

Authors
  1. Michal Tarasov
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yechiel Z. Burke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Stockheim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Raoul Orvieto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shlomo B. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yechiel Z. Burke.

Ethics declarations

Conflict of interest

All authors declare that they have no potential conflicts of interest to disclose.

Ethical approval

Institutional Review Board Approval number (Ethical approval): 4775-17-SMC.

Informed consent

All participants gave informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tarasov, M., Burke, Y.Z., Stockheim, D. et al. Does the time interval between the diagnosis to hysteroscopic evacuation of retained products of conception affect reproductive outcome?. Arch Gynecol Obstet 302, 1523–1528 (2020). https://doi.org/10.1007/s00404-020-05711-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-020-05711-2

Keywords

Search

Navigation