Retained products of conception - a retrospective analysis of 200 cases of surgical procedures for the diagnosis of residua postpartum.
| Autor: | Velebil P; 3rd Faculty of Medicine, Institute for the Care of Mother and Child, Charles University, Prague, Czech Republic., Hympanova LH; 3rd Faculty of Medicine, Institute for the Care of Mother and Child, Charles University, Prague, Czech Republic., Herman H; 3rd Faculty of Medicine, Institute for the Care of Mother and Child, Charles University, Prague, Czech Republic., Emingr M; 3rd Faculty of Medicine, Institute for the Care of Mother and Child, Charles University, Prague, Czech Republic., Krepelka P; 3rd Faculty of Medicine, Institute for the Care of Mother and Child, Charles University, Prague, Czech Republic., Hanacek J; 3rd Faculty of Medicine, Institute for the Care of Mother and Child, Charles University, Prague, Czech Republic. jiri.hanacek@upmd.eu. |
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| Jazyk: | angličtina |
| Zdroj: | Ginekologia polska [Ginekol Pol] 2023; Vol. 94 (12), pp. 967-971. Date of Electronic Publication: 2023 Jul 12. |
| DOI: | 10.5603/GP.a2023.0068 |
| Abstrakt: | Objectives: Postpartum retained products of conception are a relatively rare diagnosis occurring in approximately 1% of cases after spontaneous deliveries and abortions. The most common clinical signs are bleeding and abdominal pain. The diagnosis is based on clinical signs and ultrasound examination. Material and Methods: Retrospective analysis of 200 surgical procedures for the diagnosis of residua postpartum obtained in 64 months. We correlated the method and accuracy of diagnosis with definitive histological findings. Results: During 64 months, we performed 23 412 deliveries. The frequency of procedures for diagnosis of retained products of conception (RPOC) was 0.85%. Most (73.5%) of the D&C were performed within six weeks of delivery. Histologically, the correct diagnosis was confirmed in 62% (chorion + amniotic envelope). There was interestingly lower concordance of histologically confirmed RPOC in post-CS patients (only 42%). In women after spontaneous delivery of the placenta, the diagnosis of RPOC was confirmed by histological correlate in 63%, and the highest concordance occurred in women after manual removal of the placenta in 75%. Conclusions: Concordance with histological findings of chorion or amnion was seen in 62% of cases; this means that the incidence rate in our study was around 0.53%. The lowest concordance is after CS deliveries, 42%. D&C for RPOC should be performed after adequate clinical evaluation and in the knowledge of 38% false positivity. There is certainly more space for a conservative approach under appropriate clinical conditions, especially in patients after CS. |
| Databáze: | MEDLINE |
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