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Hysteroscopy In Pregnancy-Related Conditions: Descriptive Analysis In 273 Patients.
MedLine Citation:
PMID:  24280360     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To describe the feasibility of office hysteroscopy in patients with pregnancy-related problems such as retained trophoblastic tissue, persistent molar tissue, pregnancy with in situ IUD, isthmocele, embryoscopy and osseous metaplasia.
DESIGN: Retrospective cohort chart review on the utility of hysteroscopy in 273 patients with pregnancy-related problems.
DESIGN: Classification: Canadian Task Classification Force II-2 SETTING: University tertiary Hospital.
DESIGN: And Patients: Office hysteroscopies with the indication of pregnancy-related problems as retained trophoblastic tissue, pregnancy and IUD, molar pregnancies, cesarean scar defects, and fetal demise were studied. 273 patients (2.6%) were selected: 185 with retained trophoblastic tissue, 14 persistent molar tissue, 7 patients with an in situ IUD, 22 with symptomatic isthmocele, 41 embryoscopies, and 4 osseous metaplasia INTERVENTION: Application of diagnostic and operative office hysteroscopy.
MEASUREMENTS: The variables studied were the resolution of abnormal uterine bleeding in the patients with persistent trophoblastic tissue, the normalization of β-hCG levels in the patients with persistent molar tissue, the continuation of pregnancies after the retrieval of lost IUDs in pregnant patients, the resolution of postmenstrual bleeding in the symptomatic isthmocele, the rate of uncontaminated embryonic tissue after embryoscopic biopsy and the successful extraction of bony tissue in patients with osseous metaplasia.
MAIN RESULTS: Office hysteroscopy was able to resolve most of cases of retained trophoblastic tissue (91.8%), as well as the totality of persistent molar tissue (14 patients). 7 IUDs (100%) were extracted in pregnant patients. 15 isthmoceles were resolved with office hysteroscopy while 7 had to be taken to the operating theatre for resectoscopy. A normal karyotype was obtained in 37 embryoscopies (90.2%) and 4 osseous metaplasia were resolved either with office hysteroscopy (75%) or in the theater by means of resectoscopy (25%).
CONCLUSION: Office hysteroscopy is a safe, minimally invasive treatment for pregnancy-related conditions with good clinical and functional results.
Authors:
Tirso Pérez-Medina; Javier Sancho-Saúco; Mar Ríos; Augusto Pereira; Nuria Argila; Elena Cabezas; Enrique Cayuela
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-23
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  -     ISSN:  1553-4669     ISO Abbreviation:  J Minim Invasive Gynecol     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101235322     Medline TA:  J Minim Invasive Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 AAGL. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, Autónoma University of Madrid , Puerta de Hierro University Hospital , Madrid, Spain. Electronic address: tperezm@sego.es.
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