Jiménez Jesús S, Gonzalez Cristina, Alvarez Carmen, Muñoz Leticia, Pérez Concha, Muñoz José L
Servicio de Ginecología y Obstetricia, Hospital Universitario 12 de Octubre, Madrid, Spain.
Eur J Obstet Gynecol Reprod Biol. 2009 Jul;145(1):89-92. doi: 10.1016/j.ejogrb.2009.04.001. Epub 2009 May 5.
To analyse the results of our conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy and to describe our experience and guidelines.
Descriptive retrospective study. Eighty-four women with suspected retained trophoblastic tissue after pregnancy underwent hysteroscopic examination and extraction of all residual tissue in the office under direct visualization of the uterine cavity, without anaesthesia or cervical dilatation.
Hysteroscopic examination was tolerated by all but one patient. In 82 cases (97.4%), the diagnosis after hysteroscopic examination was placental polyp or retained trophoblastic tissue. This diagnosis was histologically confirmed in 79 cases (94.7%). In 43.6% (36) of the cases, complete evacuation of the uterine cavity was achieved during a single hysteroscopic examination. The only complication after hysteroscopy was one case of major vaginal bleeding requiring curettage.
Diagnostic-operative ambulatory hysteroscopy is a suitable alternative to blind curettage in the management of retained trophoblastic tissue. This technique can be performed in the office without anaesthesia and with a low rate of complications.
分析门诊诊断性宫腔镜检查对妊娠后残留滋养层组织及胎盘息肉进行保守治疗的结果，并描述我们的经验和指导原则。
描述性回顾性研究。84例妊娠后疑似残留滋养层组织的女性接受了宫腔镜检查，并在直视子宫腔的情况下于门诊取出所有残留组织，无需麻醉或宫颈扩张。
除1例患者外，所有患者均耐受宫腔镜检查。82例（97.4%）宫腔镜检查后的诊断为胎盘息肉或残留滋养层组织。79例（94.7%）经组织学证实该诊断。43.6%（36例）的病例在单次宫腔镜检查时实现了子宫腔的完全排空。宫腔镜检查后唯一的并发症是1例需要刮宫的严重阴道出血。
诊断性手术门诊宫腔镜检查是处理残留滋养层组织时替代盲目刮宫的合适选择。该技术可在门诊进行，无需麻醉，并发症发生率低。
