Ultrasound in the Management of Elective Abortion

Sanders, Roger C.; Curtin, Michael J.; Tapper, Alan J.

doi:10.2214/ajr.125.2.469

Cited by 6 publications

(1 citation statement)

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“…However, the step of cervical dilatation using Hegar's dilators before the SSE has remained unchanged since 1874 [6]. Ultrasound used during surgical suction evacuation (US-SSE) of the uterine content helps to identify the uterine axis, as well as the size and position of the gestational sac, monitor the insertion of the suction evacuation cannula into the uterine cavity, ensure complete evacuation, and minimize the risk of complications [3,4,7]. This prospective comparative study was designed to evaluate the outcome of the implemented protocol of US-SSE for first trimester missed miscarriage.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided surgical suction evacuation (US-SSE) for missed miscarriage

Abdulkareem¹,

Abdelazim²,

Abu-Faza³

et al. 2018

jogi

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Introduction: Surgical evacuation of the uterine contents in first trimester missed miscarriage is a blind procedure, carrying a risk of complications. This study was designed to evaluate the outcome of the implemented protocol of ultrasound-guided surgical suction evacuation (US-SSE) for first trimester missed miscarriage. Material and methods: Two hundred and twenty women diagnosed with missed miscarriage in the first trimester of pregnancy were included in this study and classified in two groups: 124 women in the US-SSE group, and 94 women in the blind surgical suction evacuation (B-SSE) group. Outcome measures: operative time, hemoglobin loss, hospital stay, cervical trauma, uterine perforation, retained products of conception (RPOC) requiring repeat evacuation, and post-operative infection. Results: The hemoglobin loss was significantly lower in the US-SSE group compared to B-SSE (0.9 ±1.1 vs. 1.2 ±0.8 gms% ; respectively, p = 0.0006), and the hospital stay was significantly shorter in the US-SSE group compared to B-SSE (1.1 ±1.3 vs. 1.5 ±0.9 days; respectively, p = 0.0001). Cervical trauma was significantly less frequent in the US-SSE group compared to B-SSE (0 (0%) vs. 2 (2.08%); respectively, p = 0.05), and uterine perforation was significantly less frequent in the US-SSE group compared to B-SSE (0 (0%) vs. 2 (2.08%); respectively, p = 0.05). Post-operative endometritis was significantly less frequent in the US-SSE group compared to B-SSE (0 (0%) vs. 3 (3.13%); respectively, p = 0.02), and RPOC requiring repeat evacuation was significantly less frequent in the US-SSE group compared to B-SSE (0 (0%) vs. 4 (4.16%); respectively, p = 0.007). Conclusions: US-SSE for first trimester missed miscarriage is safer than the B-SSE method, and is associated with significant reduction of intra-operative and post-operative complications.

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Section: Introductionmentioning

confidence: 99%