Evaluation of the Management and Outcome of Patients with Retained Products of Conception after Gestational Week 23+0: A Retrospective Cohort Study
Retained products of conception after childbirth or miscarriage are associated with an increased rate of maternal complications, such as abnormal vaginal bleeding and infections. Late complications may also include intrauterine adhesions, causing infertility. Surgical interventions carry a certain r...
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| Veröffentlicht in: | Journal of clinical medicine 2024-08, Vol.13 (15), p.4439 |
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| creator | Pateisky, Petra Mikula, Fanny Adamovic, Marija Neumüller, Jana Chalubinski, Kinga Falcone, Veronica Springer, Stephanie |
| description | Retained products of conception after childbirth or miscarriage are associated with an increased rate of maternal complications, such as abnormal vaginal bleeding and infections. Late complications may also include intrauterine adhesions, causing infertility. Surgical interventions carry a certain risk. Thus, conservative management is often discussed as an alternative. The aim of this study was to assess the clinical outcomes of patients with retained products of conception, comparing a primary surgical approach to conservative management.
We conducted a retrospective cohort study of 88 patients diagnosed with retained products of conception after 23+0 weeks of gestation at the Medical University Vienna between 2014 and 2022.
Forty-seven (53.4%) patients underwent primary surgical management and 41 (46.6%) primary conservative management. After primary conservative treatment, a complication could be observed in 10 (24.4%) women. In contrast, complications occurred in 32 (68.1%) women in the group with primary surgical treatment (
< 0.001). The most common complication in both groups was the ongoing suspicion of retained products of conception. Patients after primary surgical treatment were significantly more likely to require a secondary change in treatment (
< 0.001). Ultimately, secondary conservative management was applied in 30 (63.8%) patients. In contrast, only nine (21.95%) patients with primary conservative management required secondary surgical management.
Due to the high risk of complications and persistent retained products of conception, primary surgical management should only be prioritized in hemodynamically instable or septic patients. |
| doi_str_mv | 10.3390/jcm13154439 |
| format | Article |
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We conducted a retrospective cohort study of 88 patients diagnosed with retained products of conception after 23+0 weeks of gestation at the Medical University Vienna between 2014 and 2022.
Forty-seven (53.4%) patients underwent primary surgical management and 41 (46.6%) primary conservative management. After primary conservative treatment, a complication could be observed in 10 (24.4%) women. In contrast, complications occurred in 32 (68.1%) women in the group with primary surgical treatment (
< 0.001). The most common complication in both groups was the ongoing suspicion of retained products of conception. Patients after primary surgical treatment were significantly more likely to require a secondary change in treatment (
< 0.001). Ultimately, secondary conservative management was applied in 30 (63.8%) patients. In contrast, only nine (21.95%) patients with primary conservative management required secondary surgical management.
Due to the high risk of complications and persistent retained products of conception, primary surgical management should only be prioritized in hemodynamically instable or septic patients.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm13154439</identifier><identifier>PMID: 39124706</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Blood ; Care and treatment ; Cesarean section ; Cohort analysis ; Gestational age ; Health aspects ; Hemorrhage ; Hysterectomy ; Infertility ; Medical records ; Miscarriage ; Obstetrical research ; Obstetrics ; Patient outcomes ; Patients ; Performance evaluation ; Physiological aspects ; Placenta ; Placental diseases ; Pregnancy ; Premature birth ; Statistical analysis ; Surgery ; Ultrasonic imaging ; Vagina ; Variables</subject><ispartof>Journal of clinical medicine, 2024-08, Vol.13 (15), p.4439</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c272t-ea541d8d6c98a235951838ca5380be13fcbb8b55e2d3f9294b9a4d2fa67ad3e93</cites><orcidid>0000-0002-5684-5630 ; 0000-0002-2412-1822 ; 0000-0003-1236-1041 ; 0000-0002-9281-3492 ; 0000-0001-5062-0097</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39124706$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pateisky, Petra</creatorcontrib><creatorcontrib>Mikula, Fanny</creatorcontrib><creatorcontrib>Adamovic, Marija</creatorcontrib><creatorcontrib>Neumüller, Jana</creatorcontrib><creatorcontrib>Chalubinski, Kinga</creatorcontrib><creatorcontrib>Falcone, Veronica</creatorcontrib><creatorcontrib>Springer, Stephanie</creatorcontrib><title>Evaluation of the Management and Outcome of Patients with Retained Products of Conception after Gestational Week 23+0: A Retrospective Cohort Study</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Retained products of conception after childbirth or miscarriage are associated with an increased rate of maternal complications, such as abnormal vaginal bleeding and infections. Late complications may also include intrauterine adhesions, causing infertility. Surgical interventions carry a certain risk. Thus, conservative management is often discussed as an alternative. The aim of this study was to assess the clinical outcomes of patients with retained products of conception, comparing a primary surgical approach to conservative management.
We conducted a retrospective cohort study of 88 patients diagnosed with retained products of conception after 23+0 weeks of gestation at the Medical University Vienna between 2014 and 2022.
Forty-seven (53.4%) patients underwent primary surgical management and 41 (46.6%) primary conservative management. After primary conservative treatment, a complication could be observed in 10 (24.4%) women. In contrast, complications occurred in 32 (68.1%) women in the group with primary surgical treatment (
< 0.001). The most common complication in both groups was the ongoing suspicion of retained products of conception. Patients after primary surgical treatment were significantly more likely to require a secondary change in treatment (
< 0.001). Ultimately, secondary conservative management was applied in 30 (63.8%) patients. In contrast, only nine (21.95%) patients with primary conservative management required secondary surgical management.
Due to the high risk of complications and persistent retained products of conception, primary surgical management should only be prioritized in hemodynamically instable or septic patients.</description><subject>Blood</subject><subject>Care and treatment</subject><subject>Cesarean section</subject><subject>Cohort analysis</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Hemorrhage</subject><subject>Hysterectomy</subject><subject>Infertility</subject><subject>Medical records</subject><subject>Miscarriage</subject><subject>Obstetrical research</subject><subject>Obstetrics</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Performance evaluation</subject><subject>Physiological aspects</subject><subject>Placenta</subject><subject>Placental diseases</subject><subject>Pregnancy</subject><subject>Premature birth</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Ultrasonic imaging</subject><subject>Vagina</subject><subject>Variables</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkt9PFDEQxzdGIwR58t008cWEHPbH9rb17XJBNMFABOPjZradcnvutke3i-Hv4B-me6CAsX3oZPr5fjOdTlG8ZfRQCE0_rk3PBJNlKfSLYpfTqppRocTLJ_FOsT8Ma5qXUiVn1etiR2jGy4rOd4vbo2voRkht8CQ4klZIvoGHS-zRJwLektMxmdDjdHuWuZweyO82rch3TNB6tOQsBjuanM7IMniDm60duISRHOOQtvbQkZ-IvwgXB_QTWUzyGIYNmtReY9atQkzkPI325k3xykE34P7DuVf8-Hx0sfwyOzk9_rpcnMwMr3iaIciSWWXnRivgQmrJlFAGpFC0QSacaRrVSIncCqe5LhsNpeUO5hVYgVrsFR_ufTcxXI25zrpvB4NdBx7DONSC5jYpySqZ0ff_oOswxvymLUU1l0LyR-oSOqxb70KKYCbTeqFoKRnTeqIO_0PlbbFvTfDo2px_Jji4F5jcsCGiqzex7SHe1IzW0xTUT6Yg0-8eSh2bHu1f9s-fizujp6ua</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Pateisky, Petra</creator><creator>Mikula, Fanny</creator><creator>Adamovic, Marija</creator><creator>Neumüller, Jana</creator><creator>Chalubinski, Kinga</creator><creator>Falcone, Veronica</creator><creator>Springer, Stephanie</creator><general>MDPI AG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5684-5630</orcidid><orcidid>https://orcid.org/0000-0002-2412-1822</orcidid><orcidid>https://orcid.org/0000-0003-1236-1041</orcidid><orcidid>https://orcid.org/0000-0002-9281-3492</orcidid><orcidid>https://orcid.org/0000-0001-5062-0097</orcidid></search><sort><creationdate>20240801</creationdate><title>Evaluation of the Management and Outcome of Patients with Retained Products of Conception after Gestational Week 23+0: A Retrospective Cohort Study</title><author>Pateisky, Petra ; 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Late complications may also include intrauterine adhesions, causing infertility. Surgical interventions carry a certain risk. Thus, conservative management is often discussed as an alternative. The aim of this study was to assess the clinical outcomes of patients with retained products of conception, comparing a primary surgical approach to conservative management.
We conducted a retrospective cohort study of 88 patients diagnosed with retained products of conception after 23+0 weeks of gestation at the Medical University Vienna between 2014 and 2022.
Forty-seven (53.4%) patients underwent primary surgical management and 41 (46.6%) primary conservative management. After primary conservative treatment, a complication could be observed in 10 (24.4%) women. In contrast, complications occurred in 32 (68.1%) women in the group with primary surgical treatment (
< 0.001). The most common complication in both groups was the ongoing suspicion of retained products of conception. Patients after primary surgical treatment were significantly more likely to require a secondary change in treatment (
< 0.001). Ultimately, secondary conservative management was applied in 30 (63.8%) patients. In contrast, only nine (21.95%) patients with primary conservative management required secondary surgical management.
Due to the high risk of complications and persistent retained products of conception, primary surgical management should only be prioritized in hemodynamically instable or septic patients.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>39124706</pmid><doi>10.3390/jcm13154439</doi><orcidid>https://orcid.org/0000-0002-5684-5630</orcidid><orcidid>https://orcid.org/0000-0002-2412-1822</orcidid><orcidid>https://orcid.org/0000-0003-1236-1041</orcidid><orcidid>https://orcid.org/0000-0002-9281-3492</orcidid><orcidid>https://orcid.org/0000-0001-5062-0097</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central |
| subjects | Blood Care and treatment Cesarean section Cohort analysis Gestational age Health aspects Hemorrhage Hysterectomy Infertility Medical records Miscarriage Obstetrical research Obstetrics Patient outcomes Patients Performance evaluation Physiological aspects Placenta Placental diseases Pregnancy Premature birth Statistical analysis Surgery Ultrasonic imaging Vagina Variables |
| title | Evaluation of the Management and Outcome of Patients with Retained Products of Conception after Gestational Week 23+0: A Retrospective Cohort Study |
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