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Erschienen in: Archives of Gynecology and Obstetrics 3/2020

01.03.2020 | General Gynecology

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

verfasst von: Ahmet Namazov, Natanel Elkabetz, Ela Ivshin, Efraim Zohav, Simon Shenhav, Victoria Kapustian, Eyal Y. Anteby, Ofer Gemer

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 3/2020

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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.
Literatur
1.
Zurück zum Zitat Deneux-Tharaux C, Macfarlane A, Winter C, Zhang WH et al (2009) Policies for manual removal of placenta at vaginal delivery: variations in timing within Europe. BJOG 116:119–124CrossRef Deneux-Tharaux C, Macfarlane A, Winter C, Zhang WH et al (2009) Policies for manual removal of placenta at vaginal delivery: variations in timing within Europe. BJOG 116:119–124CrossRef
2.
Zurück zum Zitat Weeks AD (2008) The retained placenta. Best Pract Res Clin Obstet Gynaecol 22:1103–1117CrossRef Weeks AD (2008) The retained placenta. Best Pract Res Clin Obstet Gynaecol 22:1103–1117CrossRef
3.
Zurück zum Zitat Cheung WM, Hawkes A, Ibish S, Weeks AD (2011) The retained placenta: historical and geographical rate variations. J Obstet Gynaecol 31:37–42CrossRef Cheung WM, Hawkes A, Ibish S, Weeks AD (2011) The retained placenta: historical and geographical rate variations. J Obstet Gynaecol 31:37–42CrossRef
4.
Zurück zum Zitat Combs CA, Laros RK (1991) Prolonged third stage of labor: morbidity and risk factors. Obstet Gynecol 77:863–867PubMed Combs CA, Laros RK (1991) Prolonged third stage of labor: morbidity and risk factors. Obstet Gynecol 77:863–867PubMed
5.
Zurück zum Zitat Weeks AD (2003) Placental influences on the rate of labour progression: a pilot study. Eur J Obstet Gynecol Reprod Biol 106:158–159CrossRef Weeks AD (2003) Placental influences on the rate of labour progression: a pilot study. Eur J Obstet Gynecol Reprod Biol 106:158–159CrossRef
6.
Zurück zum Zitat Hrazdirova L, Svabik K, Zizka Z, Germanova A, Kuzel D (2012) Should hysteroscopy be provided for patients who have undergone instrumental intrauterine intervention after delivery? Acta Obstet Gynecol Scand 91:514–517CrossRef Hrazdirova L, Svabik K, Zizka Z, Germanova A, Kuzel D (2012) Should hysteroscopy be provided for patients who have undergone instrumental intrauterine intervention after delivery? Acta Obstet Gynecol Scand 91:514–517CrossRef
7.
Zurück zum Zitat Rosenstein MG, Vargas JE, Drey EA (2014) Ultrasound-guided instrumental removal of the retained placenta after vaginal delivery. Am J Obstet Gynecol 211(180):e1–e3 Rosenstein MG, Vargas JE, Drey EA (2014) Ultrasound-guided instrumental removal of the retained placenta after vaginal delivery. Am J Obstet Gynecol 211(180):e1–e3
8.
Zurück zum Zitat Weissbach T, Haikin-Herzberger E, Bacci-Hugger K, Shechter-Maor G, Fejgin M, Biron-Shental T (2015) Immediate postpartum ultrasound evaluation for suspected retained placental tissue in patients undergoing manual removal of placenta. Eur J Obstet Gynecol Reprod Biol 192:37–40CrossRef Weissbach T, Haikin-Herzberger E, Bacci-Hugger K, Shechter-Maor G, Fejgin M, Biron-Shental T (2015) Immediate postpartum ultrasound evaluation for suspected retained placental tissue in patients undergoing manual removal of placenta. Eur J Obstet Gynecol Reprod Biol 192:37–40CrossRef
9.
Zurück zum Zitat Anteby M, Many A, Ashwal E, Yogev Y, Shinar S (2019) Risk factors and complications of manual placental removal after vaginal delivery: How common are additional invasive procedures? J Matern Fetal Neonatal Med 32:384–388CrossRef Anteby M, Many A, Ashwal E, Yogev Y, Shinar S (2019) Risk factors and complications of manual placental removal after vaginal delivery: How common are additional invasive procedures? J Matern Fetal Neonatal Med 32:384–388CrossRef
10.
Zurück zum Zitat Sotiriadis A, Makrydimas G, Papatheodorou S, Ioannidis JP (2005) Expectant, medical, or surgical management of first-trimester miscarriage: a meta-analysis. Obstet Gynecol 105:1104–1113CrossRef Sotiriadis A, Makrydimas G, Papatheodorou S, Ioannidis JP (2005) Expectant, medical, or surgical management of first-trimester miscarriage: a meta-analysis. Obstet Gynecol 105:1104–1113CrossRef
11.
Zurück zum Zitat Nanda K, Peloggia A, Grimes D, Lopez L, Nanda G (2006) Expectant care versus surgical treatment for miscarriage. Cochrane Database Syst Rev 2:CD003518 Nanda K, Peloggia A, Grimes D, Lopez L, Nanda G (2006) Expectant care versus surgical treatment for miscarriage. Cochrane Database Syst Rev 2:CD003518
12.
Zurück zum Zitat 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 103:775–779CrossRef 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 103:775–779CrossRef
13.
Zurück zum Zitat Hooker AB, Muller LT, Paternotte E, Thurkow AL (2015) Immediate and long-term complications of delayed surgical management in the postpartum period: a retrospective analysis. J Matern Fetal Neonatal Med 28(16):1884–1889CrossRef Hooker AB, Muller LT, Paternotte E, Thurkow AL (2015) Immediate and long-term complications of delayed surgical management in the postpartum period: a retrospective analysis. J Matern Fetal Neonatal Med 28(16):1884–1889CrossRef
14.
Zurück zum Zitat Melcer Y, Smorgick N, Schneider D, Pansky M, Halperin R, Ben-Ami I (2016) Infertility Following retained products of conception: Does the timing of surgical ıntervention matter? Isr Med Assoc J 18:605–608PubMed Melcer Y, Smorgick N, Schneider D, Pansky M, Halperin R, Ben-Ami I (2016) Infertility Following retained products of conception: Does the timing of surgical ıntervention matter? Isr Med Assoc J 18:605–608PubMed
15.
Zurück zum Zitat Vitner D, Filmer S, Goldstein I, Khatib N, Weiner Z (2013) A comparison between ultrasonography and hysteroscopy in the diagnosis of uterine pathology. Eur J Obstet Gynecol Reprod Biol 171(1):143–145CrossRef Vitner D, Filmer S, Goldstein I, Khatib N, Weiner Z (2013) A comparison between ultrasonography and hysteroscopy in the diagnosis of uterine pathology. Eur J Obstet Gynecol Reprod Biol 171(1):143–145CrossRef
Metadaten
Titel
Routine ultrasonographic and hysteroscopic evaluations of women undergoing postpartum manual removal of placenta: a retrospective cohort study
verfasst von
Ahmet Namazov
Natanel Elkabetz
Ela Ivshin
Efraim Zohav
Simon Shenhav
Victoria Kapustian
Eyal Y. Anteby
Ofer Gemer
Publikationsdatum
01.03.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 3/2020
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-020-05433-5

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