Document Detail


Gestational sac aspiration: a novel alternative to dilation and evacuation for management of early pregnancy failure.
MedLine Citation:
PMID:  16825069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To explore the effectiveness (success, safety, and complications) of a novel technique of gestational sac aspiration in the management of early pregnancy failure as an alternative to dilation and evacuation (D&E) and conservative management. DESIGN: Prospective historical cohort study comparing effectiveness of gestational sac aspiration (study group) to conservative management (control group) with follow-up until negative quantitative beta human chorionic gonadotropin testing is achieved (Canadian Task Force classification II-1). SETTING: An infertility treatment center. PATIENTS: Among 60 women with failed early pregnancies that were achieved by in vitro fertilization or intrauterine insemination, 20 underwent gestational sac aspiration, whereas 40 chose conservative management. INTERVENTIONS: Gestational sac aspiration was done by transvaginal ultrasound-guided needle aspiration under conscious sedation. Aspirated tissue was sent for karyotyping. Both study and control (conservative management) groups received close follow-up with ultrasound and serial beta human chorionic gonadotropin measurements. MEASUREMENTS AND MAIN RESULTS: There was no significant difference in age, infertility factor, or treatment between study and control groups. Mean gestational age was 8 versus 6 weeks in study and control groups, respectively (p < .05). One and 11 patients required D&E in the study and control groups, respectively (p < .05). Karyotyping was successful in all except one patient in the study group. Chromosomal abnormalities were found in 36% of products of conception. No significant complications occurred CONCLUSION: Gestational sac aspiration is a simple and safe outpatient technique that is more effective than conservative management of early pregnancy failure and less invasive than D&E. Moreover, the technique provides a high probability of obtaining a noncontaminated adequate gestation tissue sample for chromosomal study.
Authors:
Mohamed F Mitwally; Hafsa Albuarki; Michael P Diamond; Mostafa Abuzeid; Michael M Fakih
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  13     ISSN:  1553-4650     ISO Abbreviation:  -     Publication Date:    2006 Jul-Aug
Date Detail:
Created Date:  2006-07-07     Completed Date:  2006-08-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101235322     Medline TA:  J Minim Invasive Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  296-301     Citation Subset:  IM    
Affiliation:
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University, Detroit, USA. mmitwally@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Abortion, Incomplete / surgery*,  ultrasonography
Adult
Chorionic Gonadotropin, beta Subunit, Human / blood
Conscious Sedation
Female
Fertilization in Vitro
Gestational Age
Humans
Insemination, Artificial
Middle Aged
Pregnancy
Pregnancy Trimester, First
Prospective Studies
Ultrasonography, Prenatal
Vacuum Curettage / methods*
Vagina / ultrasonography
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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