Sonographic Endometrial Characteristics Associated with Subsequent Surgical Intervention After Medical Termination of
Heng-Kien Au1,2, Meng-Chen Tsai1, Li-Wei Chien1,2
1Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei City, Taiwan.
Background:
This study aimed to identify factors of surgical intervention following medical termination of pregnancy (MTOP) of early pregnancy loss (EPL), using gestational age determined by transvaginal ultrasonography.
Methods:
A retrospective study was conducted of women who underwent MTOP for EPL at a single tertiary hospital between 2010 and 2019. The treatment protocol consisted of oral mifepristone (600 mg), followed by oral misoprostol (600 mcg) 48 h later. A transvaginal ultrasound was performed 14-16 days after mifepristone administration to evaluate endometrial morphology. Patients were classified into three groups according to ultrasound-determined gestational age. MTOP failure was defined as the need for surgical evacuation.
Results:
Among the 534 patients, 39 (7.3%) required surgical management. Gestational age ≤7+ weeks was not associated with MTOP outcomes. All women exhibiting a linear endometrial midline or homogeneous endometrium appearance achieved complete uterine evacuation (p < 0.001). Multivariate logistic regression identified increased endometrium thickness (adjusted odds ratio [aOR]: 1.43, 95% CI: 1.25-1.62, p < 0.001) and non-clear endometrial-myometrial margin (aOR: 8.88, 95% CI: 3.26-24.15, p < 0.001) as factors associated with MTOPs failure.
Conclusions:
Sonographic endometrial assessment approximately two weeks after MTOP provides clinically relevant indicators of treatment success.
More Related Videos
11:29Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
03:01Author Spotlight: A Reproductive Hysteroscopy Approach for Complete Endometrial Polyp Removal and Enhanced Endometrial Receptivity
Published on: August 2, 2024