Retrospective comparation of three surgical interventions for retained products of conception (RPOC) following terminations of pregnancy in the second and third trimesters: a single center study.

OBJECTIVES

This study aimed to report our experience and explore optimal surgical interventions for treating retained products of conception (RPOC) following second and third-trimester pregnancies.

MATERIAL AND

METHODS

Medical records of women who underwent either ultrasound-guided dilatation and curettage (D&C) or hysteroscopic electroresection of RPOC at the Fourth Hospital of Shijiazhuang, Hebei province, China, between 2018 and 2022 were retrospectively reviewed. The patients were divided into three groups based on surgical methods and intervention timing. Group A underwent D&C within two weeks to one month after diagnosis (n = 60), Group B had hysteroscopic electroresection within the same timeframe (n = 60), and Group C underwent hysteroscopic electroresection within 1 to 2 months after diagnosis (n = 60). Intraoperative conditions and postoperative complications were compared among three groups.

RESULTS

Mean surgical times were 25.20 ± 7.70 minutes in Group A, 39.38 ± 9.25 minutes in Group B, and 24.50 ± 7.49 minutes in Group C, with significant differences between Groups A and B, as well as B and C (p = 0.0000). Intraoperative bleeding volumes were 128.62 ± 13.15 mL in Group A, 79.35 ± 11.23 mL in Group B, and 30.18 ± 9.85 mL in Group C, showing significant intergroup differences (p = 0.0000). Secondary surgeries occurred in 12 cases in Group A, one case in Group B, and none in Group C (p = 0.0023). The rate of postoperative intrauterine adhesion (IUA) was highest in Group A (p = 0.0012). Intraoperative complications occurred in one case in Group A, two cases in Group B, and none in Group C.

CONCLUSIONS

Hysteroscopic electroresection for RPOC within the specified timeframes resulted in shorter operation times, reduced bleeding, lower IUA rate, and fewer secondary surgeries compared to D&C or earlier electroresection.