Evaluation of fertility after operative hysteroscopy to remove retained products of conception

Evaluation of fertility after operative hysteroscopy to remove retained products of conception.

To study fertility after operative hysteroscopy for the management of prolonged trophoblastic retention, and the complications of this procedure.

Retrospective cohort in a university hospital.

115 patients underwent operative hysteroscopy for the treatment of prolonged post-partum and post-abortum retention between January 2008 and December 2011. Of the 115 patients included in this study, 53 desired a postoperative pregnancy. Using the survival model, the conception rate was 71.1% (95%CI; 58.1-82.9) at 6 months and 83.5% (95%CI; 71.8-92.2) at 1year. The overall rate of intraoperative complications was 15%. The rate of complications≥grade 3 was 5%. Logistic regression analysis showed that only retentions of greater than 25mm were associated with complications generally (aOR=7.4; 95%CI; 2.3-24.5) and with Clavien-Dindo complications≥grade 3 (OR=27.2; 95%CI; 2.8-263).

The management of prolonged retention by operative hysteroscopy allows the preservation of future fertility. There are more complications when the retentions are >25mm.