Reproductive and Obstetric Outcomes Following Operative Hysteroscopy for Treatment of Retained Products of Conception: Does Time from Surgery to Conception Matter?

Study Objective To evaluate reproductive and obstetric outcomes following operative hysteroscopy for treatment of retained products of conception (RPOC). We also investigated the effect of time interval between operative hysteroscopy and pregnancy on these outcomes. Design Retrospective cohort study. Setting The study was conducted at the gynecology department of a tertiary teaching hospital between January 2012 and December 2016. Patients or Participants Women who underwent operative hysteroscopy for treatment of RPOC and who became pregnant following the procedure. Interventions All women in the study underwent operative hysteroscopy with resection of RPOC. Measurements and Main Results Demographic, pre-operative, intra-operative, post-operative, reproductive and obstetric data were retrieved from electronic medical records. All patients were contacted via telephone questionnaire during which data regarding reproductive and obstetric outcomes of the pregnancy following the surgical procedure were collected. To determine the effect of time interval between operative hysteroscopy and pregnancy on reproductive and obstetric outcomes the cohort was divided into two groups: women who conceived 6 months or less following surgery and women who conceived more than 6 months after operative hysteroscopy. Eighty-two women who underwent operative hysteroscopy for treatment of RPOC and who conceived later were included. Mean time from women's attempt to conceive to conception was 4.32 (SD=5.31) months. Conception rate was 84.2% at 6 months and reached 92.7% at 12 months post-surgery. Miscarriage rate for the consecutive pregnancy following hysteroscopy was 16.7% and delivery rate was 83.3%. Two cases of obstetric complications including one case of retained placenta and one case of post-partum hemorrhage were noted. Time interval between operative hysteroscopy and pregnancy did not affect reproductive or obstetric outcomes. Conclusion Women treated by operative hysteroscopy for RPOC have positive reproductive and obstetric outcomes. Time interval between the procedure and pregnancy has no effect on these outcomes.