Sonnier Louise, Torre Antoine, Broux Pauline, Fauconnier Arnaud, Huchon Cyrille
Service de Gynécologie-Obstétrique, Centre Hospitalier Intercommunal de Poissy Saint Germain, 10 rue du Champ Gaillard, 78300 Poissy, France.
Service de Gynécologie-Obstétrique, Centre Hospitalier Intercommunal de Poissy Saint Germain, 10 rue du Champ Gaillard, 78300 Poissy, France.
Eur J Obstet Gynecol Reprod Biol. 2017 Apr;211:98-102. doi: 10.1016/j.ejogrb.2017.02.003. Epub 2017 Feb 6.
Evaluation of fertility after operative hysteroscopy to remove retained products of conception.
To study fertility after operative hysteroscopy for the management of prolonged trophoblastic retention, and the complications of this procedure.
Retrospective cohort in a university hospital.
115 patients underwent operative hysteroscopy for the treatment of prolonged post-partum and post-abortum retention between January 2008 and December 2011. Of the 115 patients included in this study, 53 desired a postoperative pregnancy. Using the survival model, the conception rate was 71.1% (95%CI; 58.1-82.9) at 6 months and 83.5% (95%CI; 71.8-92.2) at 1year. The overall rate of intraoperative complications was 15%. The rate of complications≥grade 3 was 5%. Logistic regression analysis showed that only retentions of greater than 25mm were associated with complications generally (aOR=7.4; 95%CI; 2.3-24.5) and with Clavien-Dindo complications≥grade 3 (OR=27.2; 95%CI; 2.8-263).
The management of prolonged retention by operative hysteroscopy allows the preservation of future fertility. There are more complications when the retentions are >25mm.
宫腔镜手术清除妊娠物残留后的生育力评估。
研究宫腔镜手术治疗滋养细胞长期残留后的生育力及该手术的并发症。
某大学医院的回顾性队列研究。
2008年1月至2011年12月期间，115例患者接受了宫腔镜手术治疗产后及流产后长期残留。本研究纳入的115例患者中，53例希望术后妊娠。采用生存模型，6个月时受孕率为71.1%（95%可信区间；58.1 - 82.9），1年时为83.5%（95%可信区间；71.8 - 92.2）。术中并发症总发生率为15%。≥3级并发症发生率为5%。逻辑回归分析显示，仅大于25mm的残留通常与并发症相关（调整后比值比=7.4；95%可信区间；2.3 - 24.5），与Clavien - Dindo≥级并发症相关（比值比=27.2；95%可信区间；2.8 - 263）。
宫腔镜手术治疗长期残留可保留未来生育力。残留>25mm时并发症更多。
