Michael Chaikof1,2, Tal Lazer1,2, Itai Gat1,2,3, Kevin Quach2, Basheer Alkudmani1,2, Khaled Zohni1,2,3, Ari Baratz1,2,4,5, Karen Glass1,2,5, Prati Sharma1,2,5, Clifford Librach6,2,5. 1. Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada. 2. CReATe Fertility Centre, Toronto, Canada. 3. Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat Gan, Israel. 4. Department of Reproductive Health and Family Planning, National Research Centre, Cairo, Egypt. 5. Department of Gynecology, Women's College Hospital, Toronto, Canada. 6. Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada - drlibrach@createivf.com.
Abstract
BACKGROUND: Missed abortion (MA) can be managed expectantly, medically or surgically. Surgical management has been performed safely in the office setting by suction dilation and curettage (D&C). Prior studies suggest that intraoperative ultrasound guidance (USG) may reduce complications for first-trimester therapeutic abortion. The aim of this study was to evaluate the safety of office D&C for MA using real-time USG. METHODS: This retrospective cohort study included 255 patients who underwent office D&C under USG for first trimester MA at a single university-affiliated fertility clinic during January 2011-December 2013. Transabdominal USG was utilized during the procedure and was immediately followed by a transvaginal ultrasound examination to confirm full evacuation. Intra- and postoperative complication rates were compared to previously published data. RESULTS: There were no intraoperative complications, including excessive blood loss or uterine perforation. Two of the 255 patients (0.87%) were diagnosed with RPOCs requiring uterine re-evacuation. This rate of RPOCs was superior to rates previously reported for D&Cs without USG (2.6-4.9%, P=0.046). There were no other post procedure complications identified. CONCLUSIONS: We observed very low complications rate in Office-based D&C under USG, lower than those reported in the literature with unguided D&C.
BACKGROUND: Missed abortion (MA) can be managed expectantly, medically or surgically. Surgical management has been performed safely in the office setting by suction dilation and curettage (D&C). Prior studies suggest that intraoperative ultrasound guidance (USG) may reduce complications for first-trimester therapeutic abortion. The aim of this study was to evaluate the safety of office D&C for MA using real-time USG. METHODS: This retrospective cohort study included 255 patients who underwent office D&C under USG for first trimester MA at a single university-affiliated fertility clinic during January 2011-December 2013. Transabdominal USG was utilized during the procedure and was immediately followed by a transvaginal ultrasound examination to confirm full evacuation. Intra- and postoperative complication rates were compared to previously published data. RESULTS: There were no intraoperative complications, including excessive blood loss or uterine perforation. Two of the 255 patients (0.87%) were diagnosed with RPOCs requiring uterine re-evacuation. This rate of RPOCs was superior to rates previously reported for D&Cs without USG (2.6-4.9%, P=0.046). There were no other post procedure complications identified. CONCLUSIONS: We observed very low complications rate in Office-based D&C under USG, lower than those reported in the literature with unguided D&C.
Authors: Hassan Aboughalia; Deepashri Basavalingu; Margarita V Revzin; Laura E Sienas; Douglas S Katz; Mariam Moshiri Journal: Abdom Radiol (NY) Date: 2021-06-15
Authors: Karen Grewal; Benjamin Jones; Ariadne L'Heveder; Sita Jindal; Nicolas Galazis; Srdjan Saso; Joseph Yazbek Journal: Future Sci OA Date: 2021-01-12