The predictors of retained products of conception following first-trimester pregnancy termination with manual vacuum aspiration

İnal, Murat; Yıldırım, Yusuf; Ertopcu, Kenan; Özelmas, İsa

doi:10.1080/13625180500456742

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…An extensive review of the literature on uterine evacuation for induced early abortion have documented that MVA was highly effective achieving complete uterine evacuation in 98% cases. 22 Present study shows that increased patient age, parity, extremes of gestational age and high BMI are associated with incomplete evacuation which is comparable with result of Inal et al 23 World Health Organization has listed MVA as an effective and safe method of uterine evacuation and hence the technique is being employed extensively in developing world under minimal anesthesia or sedation in managenment of incomplete miscarriages. 25 However, there in minimal available data regarding its use in missed miscarriages.…”

Section: Discussionsupporting

confidence: 90%

Effectiveness of Manual Vacuum Aspiration in Missed Miscarriage of Less Than 12 Weeks Gestation

Ambreen¹,

Intsar²,

Malhotra³

2013

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objective:To determine the effectiveness of manual vaccum aspiration in missed miscarriage of less than 12 weeks gestation.Place and duration of study: Department of Obstetric and gynecology, Fatima Memorial Hospital, Lahore for a period of 6 months from March 2012 to August 2012 and 87 patients with missed miscarriage were included in the study. In all patients evacuation was done by Manual Vacuum Aspiration (MVA). The data of each patient and outcome of procedure was recorded in a performa. Results:In this study MVA was 96.5% effective to evacuate the uterus up to 12 weeks gestation while in 3.5% cases procedure failed and further procedure was required to evacuate the uterus. Highest frequency of effectiveness was found in age group of between 15 and 30 years. Primiparous women had highest frequency of effective evacuation. MVA was 100% effective at gestational age between 8 and 10 weeks. Increased BMI was associated with incomplete evacuation. Conclusion:The present study shows that MVA is effective method to treat missed miscarriage of less than 12 weeks of gestation. In this study we concluded that there is an association between young patient age, low parity, early gestational age, low BMI and effectiveness of MVA.

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Section: Discussionsupporting

confidence: 90%

Effectiveness of Manual Vacuum Aspiration in Missed Miscarriage of Less Than 12 Weeks Gestation

Ambreen¹,

Intsar²,

Malhotra³

2013

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…It has recently been reported that RPOC after firsttrimester pregnancy termination was more commonly found when the procedure was performed at a more advanced gestational age. 21 Therefore, in our study, an increasing incidence of postabortion myometrial hypervascularity as gestational age advances most probably results from the increasing incidence of RPOC.…”

Section: 13mentioning

confidence: 92%

Postabortion Doppler Evaluation of the Uterus

Müngen

Dündar

Babacan

2009

J of Ultrasound Medicine

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Objective. The aim of this study was to investigate the incidence and causes of uterine hypervascular lesions showing low-impedance, high-velocity flow on color Doppler sonography (CDS) after firsttrimester dilation and curettage (D&C). Methods. This was a prospective study of 65 consecutive women who underwent first-trimester termination of pregnancy. Color Doppler sonography of the uterus was performed on days 3 and 10 after D&C. If the myometrial hypervascularity (MH) persisted on day 10, a second D&C was performed, and then the patients were followed with weekly Doppler examinations. Results. In 16 of 65 women (24.6%), MH was detected with CDS on day 3 after D&C. In 3 cases, MH resolved spontaneously by postabortion day 10. In the remaining 13 patients, the second D&C performed on day 10 revealed retained products of conception (RPOC) in 8 patients (61.5%), a hydatidiform mole in 2 (15.4%), endometritis in 1 (7.7%), and no abnormality in 2 (15.4%). Complete resolution of the MH occurred in all cases. The mean period to the resolution of MH after the second D&C ± SD was 16.54 ± 11.06 days (range, 7-48 days). Univariate analysis revealed that gestational age at D&C (P = .012) and a history of any uterine surgery (P = .044) were significantly associated with postabortion MH. On binary logistic regression analysis, gestational age at D&C was the only independent predictive factor for MH (P = .016; odds ratio, 1.47; 95% confidence interval, 1.08-2.02). Conclusions. The presence of hypervascular areas within the myometrium is a common finding in the postabortion period, and in most cases, the cause of this finding is RPOC. Key words: abortion; color Doppler sonography; myometrial hypervascularity; uterus. he definitive diagnosis and management of postabortion and postpartum myometrial hypervascular lesions on Doppler sonography is challenging, particularly in patients with abnormal vaginal bleeding. A uterine arteriovenous malformation (AVM), a potentially life-threatening condition, is often considered in the differential diagnosis.1,2 However, an AVM of the uterus is a rare entity. In a cross-sectional study involving 385 consecutive women who underwent a transvaginal sonographic examination approximately 6 weeks after pregnancy, hypervascular areas within the myometrium were detected in 5% of women after term deliveries and in 18.9% after first-trimester miscarriages. 3In another study of 93 consecutive women in the puerperium after uncomplicated term singleton pregnancy, Van Schoubroeck et al 4 found that enhanced myometrial vascularity was observed in 50.5% of patients on postpar-

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“…Some authors describe RPOC as non-villous trophoblastic tissue, chorionic villi or foetal membranes, and they state that decidua alone does not fall within the definition [3][4][5]. Others say that RPOC consist of the gestational sac, the decidua capsularis, chorionic villi or the embryo itself [6]. Still others argue that RPOC are from placental origin, and thus, that the presence of chorionic villi in RPOC is necessary [1,7].…”

Section: Introductionmentioning

confidence: 99%

Fertility outcome after treatment of retained products of conception: a systematic review

et al. 2018

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The predictors of retained products of conception following first-trimester pregnancy termination with manual vacuum aspiration

Abstract: Our study suggests that the frequency of RPC after MVA has been affected by current pregnancy-related factors such as patient age, BMI, and gestational age rather than the prior obstetric history of the patients.

Cited by 5 publications

References 25 publications

Effectiveness of Manual Vacuum Aspiration in Missed Miscarriage of Less Than 12 Weeks Gestation

Effectiveness of Manual Vacuum Aspiration in Missed Miscarriage of Less Than 12 Weeks Gestation

Postabortion Doppler Evaluation of the Uterus

Fertility outcome after treatment of retained products of conception: a systematic review

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