Clinical outcomes after hysteroscopic removal of retained products of conception with or without prior uterine artery embolization

Skuk, Eva (avtor), Vihtelič, Polona (avtor), Popović, Peter (avtor), Kovač, Kaja (avtor), Verdenik, Ivan (avtor), Kenda Šuster, Nataša (avtor)

Purpose: Retained products of conception (RPOC) are a common complication after pregnancy. While hysteroscopic resection is the standard treatment when RPOC does not resolve spontaneously, highly vascular tissue can lead to severe bleeding during the procedure. This study assessed clinical outcomes, procedural safety, and reproductive performance in patients with highly vascular RPOC treated with uterine artery embolization (UAE) prior to hysteroscopy, compared to those treated with hysteroscopy alone. Methods: This retrospective study included 42 women diagnosed with RPOC at University Medical Centre Ljubljana, Slovenia (2010-2020). Patients were divided into two groups: UAE followed by hysteroscopic resection (UAE + HSC, n = 21) and hysteroscopic resection alone (HSC-only, n = 21). Data on clinical outcomes, complications, and reproductive history were analyzed using Fisher's exact and t-tests (p < 0.05). Results: Groups were similar in baseline characteristics, except for greater vascularity in the UAE + HSC group (100% vs. 4.8%, p < 0.05). Bleeding >300 mL occurred more often in the UAE + HSC group, but all cases were managed conservatively and only one patient required transfusion. No uterine perforations occurred. Residual RPOC was found in one patient per group. Rates of endometritis, menstrual changes, and pelvic pain were comparable. Among those who attempted conception, live birth and miscarriage rates did not differ significantly. Conclusions: UAE prior to hysteroscopic surgery appears to be a safe and effective option for highly vascular RPOC, especially in patients at risk of hemorrhage, with no adverse impact on fertility. Further prospective studies are recommended.

• Jezik: Angleški jezik
• Ključne besede: retained products of conception, uterine artery embolization, hysteroscopy, fertility, high vascularity, reproductive outcomes
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2025
• Št. strani: 10 str.
• Številčenje: Vol. 14, iss. 22, art. 8020
• PID: 20.500.12556/RUL-182307
• UDK: 618.1
• ISSN pri članku: 2077-0383
• DOI: 10.3390/jcm14228020
• COBISS.SI-ID: 275156995
• Datum objave v RUL: 08.05.2026

Gradivo je del revije

• Naslov: Journal of clinical medicine
• Skrajšan naslov: J. clin. med.
• Založnik: MDPI
• ISSN: 2077-0383
• COBISS.SI-ID: 5405759

Licence

• Licenca: CC BY 4.0, Creative Commons Priznanje avtorstva 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by/4.0/deed.sl
• Opis: To je standardna licenca Creative Commons, ki daje uporabnikom največ možnosti za nadaljnjo uporabo dela, pri čemer morajo navesti avtorja.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: plodnost, visoka prekrvavljenost, histeroskopija, reproduktivni izidi, zadržani produkti spočetja, embolizacija maternične arterije