Outcome of using vaginal misoprostol for treatment of retained products of conception after first trimester miscarriage: a retrospective cohort study

Autor:	J S Lee, S Fisher, K T Stewart, K Pan, Arianne Albert
Rok vydání:	2020
Předmět:	medicine.medical_specialty medicine.medical_treatment media_common.quotation_subject Fertility Miscarriage Cohort Studies Dilation and curettage Fetus Pregnancy medicine Humans Pharmacology (medical) Misoprostol media_common Retrospective Studies Abortifacient Agents Nonsteroidal Obstetrics business.industry Standard treatment Obstetrics and Gynecology Retrospective cohort study medicine.disease Abortion Spontaneous Pregnancy Complications First trimester Pregnancy Trimester First Reproductive Medicine Products of conception Female business medicine.drug
Zdroj:	The European journal of contraceptionreproductive health care : the official journal of the European Society of Contraception. 25(6)
ISSN:	1473-0782
Popis:	Standard treatment for retained products of conception (RPOC) is dilation and curettage (DC), however, this brings a risk of intrauterine synechiae and subsequent fertility issues. A treatment strategy to avoid DC is medical management with misoprostol. The justification for misoprostol in this setting is extrapolated from miscarriage and termination literature, however, no studies have looked specifically in the setting of RPOC. The purpose of this study is to determine the efficacy of misoprostol as definitive management of RPOC.A retrospective cohort study was conducted from January 2016 to March 2017 at an Early Pregnancy Assessment Clinic. Patients diagnosed with RPOC with clinical symptoms and ultrasound findings of endometrial mass and/or doppler flow treated expectantly, medically with vaginal misoprostol or with a suction DC underwent a chart review. Primary outcome was resolution of RPOC without surgical intervention.Of 1743 unique pregnancies, 189 women were diagnosed with RPOC. 34% (65/178) chose misoprostol for management of RPOC. Baseline demographics between the three treatment modalities (expectant, medical, surgical) were comparable. 65% (42/65) of patients who took misoprostol avoided DC. Misoprostol is most effective (76%) in the setting of RPOC if the primary treatment for miscarriage was expectant management, with less success with primary medical management (44%) and primary surgical management (40%).
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::98872b4c8a5c2cea6fe18cced444d00d https://pubmed.ncbi.nlm.nih.gov/32869658 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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