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Intrauterine adhesions after hysteroscopic treatment for retained products of conception: what are the risk factors?
Fertil Steril. 2015 Mar; 103(3):775-9.FS

Abstract

OBJECTIVE

To assess the prevalence and risk factors for intrauterine adhesions (IUAs) after hysteroscopic treatment of retained products of conception (RPOC).

DESIGN

Retrospective cohort study.

SETTING

Gynecologic endoscopy unit.

PATIENT(S)

A total of 167 women referred to our institution from 2009 to 2013.

INTERVENTION(S)

Operative hysteroscopy for treatment of RPOC and office hysteroscopic follow-up to assess for IUA.

MAIN OUTCOME MEASURE(S)

We investigated demographic characteristics, obstetrics parameters, and surgical variables to evaluate which factors could be associated with IUA formation.

RESULT(S)

Of 167 women treated for RPOC, 84 (50.3%) had undergone a follow-up hysteroscopic evaluation after the operative hysteroscopy and were included in the study. Intrauterine adhesions were found in 16 cases (19.0%), of which only 3 (3.6%) were severe adhesions. Multivariate analysis showed that the presence of IUA was associated with RPOC after cesarean section (5 of 10 [50.5%] developed IUA, vs. 7 of 49 [14.3%] after vaginal delivery). Intrauterine adhesions were also found in 4 of 23 women (17.4%) undergoing hysteroscopy for RPOC after abortion. Patient age, gravidity, parity, and the interval between the index pregnancy and treatment for RPOC were not associated with postoperative IUA.

CONCLUSION(S)

Hysteroscopic treatment for RPOC had a 3.6% incidence of severe intrauterine adhesions formation in this descriptive series. Women with RPOC occurring after delivery by cesarean section are particularly at risk for development of IUA.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Zerifin, Israel.Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Zerifin, Israel.Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Zerifin, Israel. Electronic address: mpansky@gmail.com.Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Zerifin, Israel.Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Zerifin, Israel.Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Zerifin, Israel.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25527235

Citation

Barel, Oshri, et al. "Intrauterine Adhesions After Hysteroscopic Treatment for Retained Products of Conception: what Are the Risk Factors?" Fertility and Sterility, vol. 103, no. 3, 2015, pp. 775-9.
Barel O, Krakov A, Pansky M, et al. Intrauterine adhesions after hysteroscopic treatment for retained products of conception: what are the risk factors? Fertil Steril. 2015;103(3):775-9.
Barel, O., Krakov, A., Pansky, M., Vaknin, Z., Halperin, R., & Smorgick, N. (2015). Intrauterine adhesions after hysteroscopic treatment for retained products of conception: what are the risk factors? Fertility and Sterility, 103(3), 775-9. https://doi.org/10.1016/j.fertnstert.2014.11.016
Barel O, et al. Intrauterine Adhesions After Hysteroscopic Treatment for Retained Products of Conception: what Are the Risk Factors. Fertil Steril. 2015;103(3):775-9. PubMed PMID: 25527235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrauterine adhesions after hysteroscopic treatment for retained products of conception: what are the risk factors? AU - Barel,Oshri, AU - Krakov,Ayala, AU - Pansky,Moty, AU - Vaknin,Zvi, AU - Halperin,Reuvit, AU - Smorgick,Noam, Y1 - 2014/12/17/ PY - 2014/07/28/received PY - 2014/11/11/revised PY - 2014/11/12/accepted PY - 2014/12/21/entrez PY - 2014/12/21/pubmed PY - 2016/3/5/medline KW - Adhesions KW - Asherman KW - conception KW - hysteroscopy KW - products KW - retained SP - 775 EP - 9 JF - Fertility and sterility JO - Fertil. Steril. VL - 103 IS - 3 N2 - OBJECTIVE: To assess the prevalence and risk factors for intrauterine adhesions (IUAs) after hysteroscopic treatment of retained products of conception (RPOC). DESIGN: Retrospective cohort study. SETTING: Gynecologic endoscopy unit. PATIENT(S): A total of 167 women referred to our institution from 2009 to 2013. INTERVENTION(S): Operative hysteroscopy for treatment of RPOC and office hysteroscopic follow-up to assess for IUA. MAIN OUTCOME MEASURE(S): We investigated demographic characteristics, obstetrics parameters, and surgical variables to evaluate which factors could be associated with IUA formation. RESULT(S): Of 167 women treated for RPOC, 84 (50.3%) had undergone a follow-up hysteroscopic evaluation after the operative hysteroscopy and were included in the study. Intrauterine adhesions were found in 16 cases (19.0%), of which only 3 (3.6%) were severe adhesions. Multivariate analysis showed that the presence of IUA was associated with RPOC after cesarean section (5 of 10 [50.5%] developed IUA, vs. 7 of 49 [14.3%] after vaginal delivery). Intrauterine adhesions were also found in 4 of 23 women (17.4%) undergoing hysteroscopy for RPOC after abortion. Patient age, gravidity, parity, and the interval between the index pregnancy and treatment for RPOC were not associated with postoperative IUA. CONCLUSION(S): Hysteroscopic treatment for RPOC had a 3.6% incidence of severe intrauterine adhesions formation in this descriptive series. Women with RPOC occurring after delivery by cesarean section are particularly at risk for development of IUA. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/25527235/Intrauterine_adhesions_after_hysteroscopic_treatment_for_retained_products_of_conception:_what_are_the_risk_factors L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(14)02372-3 DB - PRIME DP - Unbound Medicine ER -