Table 1.
Summary of studies comparing hysteroscopic resection to dilation and curettage for treatment of retained products of conception.
| Author, year | Study design | Sample size (n) | HR cohort outcomes: % | D&C cohort outcomes: % | P value |
|---|---|---|---|---|---|
| Hooker et al. (24), 2016 | S | 339 (10 cohort studies) HR (147) D&C (192) |
IUA: 13 | IUA: 30 | <.001 |
| Incomplete evacuation: 1 | Incomplete evacuation: 29 | <.0001 | |||
| No complications | Complications: 1.4 | NS | |||
| Conception rate: 82.4 | Conception rate: 81 | NS | |||
| Live birth rate: 88 | Live birth rate: 91.6 | NS | |||
| Miscarriage rate: 14.8 | Miscarriage rate: 14.3 | NS | |||
| Rein et al. (25), 2011 | P | HR (53) D&C (42) |
IUA: 4.2 | IUA: 30.8 | <.001 |
| Time to conception: 27 mo | Time to conception: 34 mo | <.05 | |||
| Conception rate: 68.8 | Conception rate: 59.9 | <.05 | |||
| Live birth rate: 83.9 | Live birth rate: 77.3 | NS | |||
| Miscarriage rate: 9.7 | Miscarriage rate: 13.6 | NS | |||
| Cohen et al. (26), 2001 | R | HR (46) D&C (24) |
Required second hysteroscopy 0 | Required hysteroscopy for persistent trophoblastic tissue 21 | |
| Time to conception: 7.3 mo | Time to conception: 11 mo | <.05 | |||
| Conception rate: 82.4 | Conception rate: 62.5 | NS | |||
| Live birth rate: 71.4 | Live birth rate: 70 | NS | |||
| Miscarriage rate: 7.1 | Miscarriage rate: 30 | NS | |||
| No complications | No complications | NS | |||
| Ben-Ami et al. (27), 2014 | R | HR (83) D&C (94) |
Infertility: 12 | Infertility: 24.5 | <.05 |
| Time to conception: 7.4 mo | Time to conception: 12.9 mo | <.05 | |||
| Conception rate: 92.8 | Conception rate: 92.6 | NS | |||
| Live birth rate: 87 | Live birth rate: 95.4 | NS | |||
| Miscarriage rate: 20.8 | Miscarriage rate: 12.6 | NS | |||
| Smorgick et al. (28), 2018 | R | HR (134) D&C (27) |
Live birth rate: 56 | Live birth rate: 70.4 | NS |
| Miscarriage rate: 18.7 | Miscarriage rate: 19.4 | NS | |||
| Recurrent RPOC: 11.9 | Recurrent RPOC: 33.3 | <.05 | |||
| Abnormal placentationa: 23.9 | Abnormal placentationa: 44.4 | <.05 |
Note: HR = hysteroscopic resection; D&C = dilation and curettage; S = systematic review; P = prospective; R = retrospective; IUA = intrauterine adhesions; RPOC = retained products of conception; NS = not statistically significant.
a
Placenta accreta or need for manual extraction immediately after vaginal delivery for retained placenta