Plasenta retansiyonlu olgularında histeroskopik yaklaşım ve takip sonuçları

Year 2022, Volume: 19 Issue: 3, 1406 - 1411, 30.09.2022

Bertan Akar , Eray Çalışkan

https://doi.org/10.38136/jgon.1151683

Abstract

Amaç
Plasenta retansiyonu olgularında histeroskopik yaklaşım, bulgular ve sonraki gebelik takiplerinin değerlendirilmesi.
Materyal ve Metod
2015-2021 yılları arasında plasenta retansiyonu nedeni ile tarafımıza refere edilmiş 19 kadın hastaya histeroskopik tanı ve bipolar koter ile rezeksiyon uygulandı. Olguların obstetrik hikayeleri, preoperatif, intraoperatif bulguları ve sonrasında gebelik sonuçları takip edildi.
Bulgular
Olguların ortalama yaşı 31.75.4 yıl idi. Gravida 2.71.4 olan olguların beşinde (%26.5) tekrarlayan düşük öyküsü vardı. Olguların 17’sinde (%89.6) sevk edilmeden önce iki ve daha fazla terapötik küretaj işlemi uygulanmıştı, 11’inde (%52.6) kanama ve 10’unda (%52.6) anemi vardı. Histeroskopik girişimde 7 (%36.8) olguda uterus anomalisi, üç olguda (%15.8) intrauterin sineşiler bulundu. Postoperatif 15.211 ay takipte üç (%15.8) olguda uterus içi sineşi, dört (%21.1) olguda ince endometriyum ve dört olguda infertilite izlendi. Çalışmamızda takipte gebelik hızını %68.7, eve bebek götürme hızını %56 olarak bulduk.
Tartışma
Gebelik materyalinin alınamadığı veya tekrarlayan küretaj denemelerine bağlı plasenta retansiyonu bulgusu devam eden olgularda histeroskopik yaklaşım plasenta retansiyonu eksizyonu ve ek patolojilerin tanı ve aynı anda tedavisi için etkili bir şeçenektir.

Keywords

plasenta retansiyonu, opertatif histeroskopi, rest plasenta

Hysteroscopic Approach and Follow-up Results in Cases with Placenta Retention

Abstract

Objective
Evaluation of hysteroscopic approach, findings and subsequent pregnancy follow-ups in cases of placental retention.
Methods
Between 2015 and 2021, 19 female patients who were referred to our clinic due to placental retention underwent hysteroscopic diagnosis and resection with bipolar cautery. Obstetric histories, preoperative and intraoperative findings of the cases and pregnancy outcomes were followed up.
Results
The mean age of the cases was 31.7 ±5.4 years. Gravida was 2.7 ±1.4, five (26.5%) of the cases had a history of recurrent miscarriage. Two or more therapeutic curettage procedures were performed in 17 of the cases (89.6%) in the cases before referral, 11 (52.6%) had bleeding complaints and 10 (52.6%) had anemia. During the hysteroscopic intervention, uterine anomaly was found in 7 (36.8%) cases and intrauterine synechiae were found in three cases (15.8%). After hysteroscopy during follow-up intrauterine synechia was observed in three (15.8%) cases and thin endometrium was observed in four (21.1%) cases. in the postoperative 15.2±11 months follow-up period infertility was observed in four cases. The follow-up pregnancy rate was 68.7% and take home baby rate was 56% in this study.

Conclusion
In cases of failed removal of conception material despite repeated endometrial aspiration, hysteroscopic approach is an effective one step diagnostik and treat option for removal of conceptus material and correction of accompanying pathologies.

Keywords

Placental retention, operative hysteroscopy, rest placenta

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