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Conservative management of placenta accreta: hysteroscopic resection of retained tissues.

Legendre, Guillaume; Zoulovits, Félicia Joinau; Kinn, Juliette; Senthiles, Loïc; Fernandez, Hervé.
J Minim Invasive Gynecol; 21(5): 910-3, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24768979

STUDY OBJECTIVE:

To evaluate the feasibility and the results of hysteroscopic removal of tissue after conservative management of retained placenta accreta.

DESIGN:

Retrospective study (Canadian Task Force classification II-3).SETTING: Tertiary care university hospital.PATIENTS: Twelve consecutive patients with hysteroscopic resection of retained tissues after conservative management of placenta accreta.INTERVENTION: Hysteroscopic removal of retained placenta tissue using a 24F bipolar resectoscope.

MEASUREMENTS AND MAIN RESULTS:

Twelve patients with retained placenta tissue, complete in 2 and partial in 10, were included. Mean retained placenta size on magnetic resonance imaging was 54 mm (range, 13-110 mm). Complete removal was achieved in all but 1 patient who underwent a secondary hysterectomy after the first incomplete hysteroscopic resection. Complete evacuation of the uterus was completed after 1 procedure in 5 patients, after 2 procedures in 2 patients, and after 3 procedures in 4 patients. All but 2 patients had normal menstrual bleeding after hysteroscopy. Four pregnancies occurred in our series, resulting in 1 ectopic pregnancy, 1 miscarriage, and 2 deliveries.

CONCLUSION:

Hysteroscopic resection of retained placenta seems to be a safe and effective procedure to prevent major complications and to preserve fertility in cases of conservative management of placenta accreta.
Selo DaSilva