Women's Clinic, Ghent University Hospital, Ghent, Belgium.
J Minim Invasive Gynecol. 2013 Nov-Dec;20(6):796-802. doi: 10.1016/j.jmig.2013.04.024.
To evaluate our initial experience with hysteroscopic morcellation for removal of placental remnants.
Retrospective case series (Canadian Task Force classification II-3).
University hospital and 2 teaching hospitals.
Women with histologic confirmation of placental remnants after miscarriage, termination of pregnancy, or delivery.
From January 2005 to May 2010, hysteroscopic morcellation was used for removal of placental remnants. Retrospective review of medical records was performed.
Analysis of 105 procedures was performed. In 99 procedures (94.3%), placental remnants were removed successfully at the first approach, and 90 procedures (85.7%) were without any adverse events. In 6 patients (5.7%), uterine perforation occurred, in 4 during cervical dilation and in 2 during the hysteroscopic procedure. Postoperatively, 3 patients had fever, 1 had hemorrhage, and 1 had abdominal pain. Routine second-look hysteroscopy in 23 patients revealed mild intrauterine adhesions in 1 patient (4.4%).
Hysteroscopic morcellation seems to be an effective technique for management of placental remnants. Future studies comparing various surgical treatment methods are needed to define factors that influence the ability to obtain the safest and most complete removal of placental remnants because this remains a challenging pregnancy-related condition.
评估我们在使用宫腔镜切除术切除胎盘残留方面的初步经验。
回顾性病例系列研究（加拿大工作队分类 II-3）。
大学医院和 2 所教学医院。
流产、终止妊娠或分娩后组织学证实有胎盘残留的女性。
从 2005 年 1 月至 2010 年 5 月，使用宫腔镜切除术切除胎盘残留。对病历进行回顾性分析。
对 105 例手术进行了分析。在 99 例（94.3%）手术中，胎盘残留一次性成功切除，90 例（85.7%）无任何不良事件。6 例（5.7%）患者发生子宫穿孔，其中 4 例发生在宫颈扩张过程中，2 例发生在宫腔镜检查过程中。术后，3 例患者发热，1 例患者出血，1 例患者腹痛。对 23 例患者进行常规的二次宫腔镜检查，发现 1 例（4.4%）患者有轻度宫腔粘连。
宫腔镜切除术似乎是一种有效的胎盘残留处理技术。需要进一步的研究来比较各种手术治疗方法，以确定影响安全和完整地切除胎盘残留的因素，因为这仍然是一种具有挑战性的与妊娠相关的疾病。
