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三级医疗中心妊娠物残留的管理:一项20年回顾性队列研究

Management of retained products of conception in a tertiary centre: a 20-year retrospective cohort study.

作者信息

Prša Gregor, Serdinšek Tamara, Žegura Andrić Branka

机构信息

Department of General Gynaecology and Urogynaecology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Ljubljanska ulica 5, Maribor, 2000, Slovenia.

出版信息

BMC Womens Health. 2025 Sep 26;25(1):440. doi: 10.1186/s12905-025-03995-7.

DOI:10.1186/s12905-025-03995-7
PMID:41013485
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12466049/
Abstract

BACKGROUND

Retained products of conception (RPOC) are defined as the persistence of trophoblastic tissue or placenta inside the uterine cavity after pregnancy. Management is challenging because there are no clearly defined diagnostic criteria, evidence-based guidelines, or treatment protocols. Our aim was to determine the success and complication rate of different methods of RPOC management at our tertiary centre in the last 20 years.

METHODS

We retrospectively collected data from patients with RPOC treated in our Clinic from 2003 to 2021 in three-year intervals. The following data were obtained: age, type of RPOC, type of treatment, complications, histopathological evaluation of the acquired tissue, and the need for transfusion.

CONCLUSIONS

Our study shows that hysteroscopy and D&C are highly successful methods of RPOC, however, the complication rate in D&C is significantly higher. Moreover, less invasive treatment of RPOC using expectant and medical approach is plausible, especially in asymptomatic patients.

摘要

背景

妊娠物残留(RPOC)定义为妊娠后滋养层组织或胎盘在子宫腔内持续存在。由于没有明确的诊断标准、循证指南或治疗方案,其管理颇具挑战性。我们的目的是确定过去20年在我们的三级中心不同RPOC管理方法的成功率和并发症发生率。

方法

我们回顾性收集了2003年至2021年期间每三年在我们诊所接受治疗的RPOC患者的数据。获得了以下数据:年龄、RPOC类型、治疗类型、并发症、获取组织的组织病理学评估以及输血需求。

结论

我们的研究表明,宫腔镜检查和刮宫术是RPOC的非常成功的方法,然而,刮宫术的并发症发生率明显更高。此外,对于RPOC采用期待疗法和药物疗法进行侵入性较小的治疗是可行的,尤其是对于无症状患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efd/12466049/68c696b728c8/12905_2025_3995_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efd/12466049/e1300856bb45/12905_2025_3995_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efd/12466049/2a0272406931/12905_2025_3995_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efd/12466049/68c696b728c8/12905_2025_3995_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efd/12466049/e1300856bb45/12905_2025_3995_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efd/12466049/2a0272406931/12905_2025_3995_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efd/12466049/68c696b728c8/12905_2025_3995_Fig3_HTML.jpg

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本文引用的文献

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Ultrasound features help identify patients who can undergo noninvasive management for suspected retained products of conception: a single institutional experience.超声特征有助于识别疑似妊娠组织残留患者,这些患者可以接受非侵入性治疗:单机构经验。
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使用阴道米索前列醇治疗早期流产后妊娠物残留的结局:一项回顾性队列研究。
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Does the time interval between the diagnosis to hysteroscopic evacuation of retained products of conception affect reproductive outcome?从诊断到宫腔镜下清除妊娠物残留的时间间隔会影响生殖结局吗?
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Postpartum retained products of conception: Retrospective analysis of the association with third stage of labor placental complications.产后妊娠物残留:与第三产程胎盘并发症相关性的回顾性分析
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