Outpatient Hysteroscopic Morcellation for Retained Products of Conception – a prospective single centre analysis

AIM:

Retained products of conception (RPOC) are defined as the presence of trophoblastic tissue inside the uterine cavity after the termination of first or mid-trimester pregnancy and delivery. Hysteroscopy is now the gold standard for management of RPOC as it is associated with increased surgical success and decreased intra and post operative complications as compared to blind dilatation and curettage. The aim of this study is to report our experience in management of RPOC by hysteroscopic morcellation using tissue retrieval system in an outpatient setting in Grade 0-1 as per Gutenberg's pre-operative classification.

METHOD:

 

Patients presenting with suspicion of RPOC were subjected to an Ultrasound examination in order to confirm the findings and stratify the patients into grades 0-3 as per Gutenberg's classification. All grade 0 and 1 were for a prospective analysis over a period of two years from 1st December 2020 to 30th November 2022 after Institutional Ethics Committee approval and written, informed consent. All these patients (n=84) underwent hysteroscopic morcellation of RPOC using TruClear tissue removal system (Medtronic TRS) in an office setting. Demographic data, obstetric history and preceding pregnancy outcomes, surgical findings, pain perception as per Visual Analogue scale, postoperative complications were noted. Post-operative Ultrasonography was done after 2 weeks and re-look office hysteroscopy was planned as per need. Statistical analysis was performed using the R-statistical tool version 3.5.3 and Microsoft excel.