Hysteroscopic morcellation for removal of persistent placental remnants in the uterine cornu: Two case reports
| Autor: | Yi Wang, Zhimin Li, Fan Yu, Zhen Yue, Li-Qin Zeng, Yuanyue Zhong |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty angular pregnancy Pregnancy Angular medicine.medical_treatment Placenta Uterine perforation Hysteroscopy Morcellation Ultrasonography Prenatal 03 medical and health sciences Dilation and curettage 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine Clinical Case Report placental remnants hysteroscopic morcellation medicine.diagnostic_test business.industry Uterus Myometrium General Medicine medicine.disease Angular Pregnancy Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Female Uterine cavity business Fallopian tube Research Article MyoSure |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 |
| Popis: | Rationale: Hysteroscopic morcellation is an alternative approach for the removal of placental remnants, given its advantages of safety, efficiency and good reproductive outcomes. This superiority can be even more obvious for removing persistent placental remnants in the lateral angle of the uterine cavity after repeated dilation and curettage (D&C) of an angular pregnancy, which is rarely reported. Patient concerns: Two patients who were both initially misdiagnosed as having missed intrauterine miscarriages underwent repeated suction-assisted D&C procedures and were found to have persistent placental remnants in the lateral angles of the uterine cavity. Diagnoses: Ultrasound and hysteroscopy evaluations showed that placental remnants in both cases were in the lateral uterine angles and protruding to the interstitial myometrium around the fallopian tube. We corrected the diagnosis to that of angular pregnancy according to a comprehensive consideration of the ultrasound, hysteroscopy and pathology results. Interventions: We performed MyoSure hysteroscopic morcellation for both patients and the placental remnants were removed completely without any complication. Outcomes: The patients were both scheduled for a second-look hysteroscopy 1 to 3 months after surgery, which revealed normal morphology of the uterine cavities and tubal ostia. The patients both achieved normal intrauterine pregnancies several months after surgery. Lessons: Hysteroscopic morcellation is a good alternative approach for the removal of placental remnants and should be considered in cases in which there might be a high risk of incomplete evacuation or a high risk of uterine perforation, especially in cases of angular pregnancy. |
| Databáze: | OpenAIRE |
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