Uterine and fetal findings at hysteroscopic evaluation of spontaneous abortions before D&C.
OBJECTIVE
To evaluate the diagnostic benefit of fluid hysteroscopy before dilatation and curettage (D&C) in women with missed abortion, with respect to frequency of congenital and acquired uterine anomalies and geographic relationship of uterine anomalies to nidation site.


METHODS
Prospective case study (Canadian Task Force classification II-2).


METHODS
Obstetric-gynecologic clinic of an academic teaching hospital.


METHODS
One hundred five women with one or more recurrent missed abortions.


METHODS
Hysteroscopy before D&C. Inspection of the fetus was attempted in 62 patients. Control hysteroscopy of the nonpregnant uterus was performed in 20 patients.


RESULTS
The uterine cavity was visualized in 87 patients (83%). These women had an obstetric history significant for 143 spontaneous abortions in 208 pregnancies. Except for three small, finger-shaped polyps in the tubal ostia, no uterine anomalies were detected. In 20 women control hysteroscopy of the nonpregnant uterus confirmed initial findings. The fetus was successfully visualized in 30 cases (48%). We observed one case of umbilical cord torsion at 12 weeks' gestation.


CONCLUSIONS
Absence of uterine anomalies in patients with single as well as recurrent spontaneous abortions was unexpected since it contradicts the existing literature. However, all previous data were gathered from hysteroscopies of nonpregnant uteri. Larger comparative studies are required.
Brandner
P
P
Department of Obstetrics and Gynecology, Caritasklinik St. Theresia, Academic Teaching Hospital of Saarland University, Rheinstrasse 2, D-66113 Saarbrücken, Germany.
Neis
K J
KJ
Wagner
S
S
Daub
M
M
D000022:Abortion, Spontaneous / Q000175:diagnosis* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D004107:Dilatation and Curettage / Q000379:methods; D005260:Female; D005333:Fetus / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011300:Preoperative Care; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D014599:Uterus / Q000503:physiopathology