title: Puerperal curettage after cesarean section delivery.
abstract: OBJECTIVE
  To analyze the clinical situations that leads us to carry out curettage after cesarean section, the ultrasound prior surgery, intraoperative, and pathological findings.
  
  
  METHODS
  A retrospective study of all cases of postpartum curettage after cesarean section in a level 3 maternity unit.
  
  
  RESULTS
  There were 42 curettages to women with cesarean sections (1.6% of all cesarean sections). The indications for curettage were: fever: 21, methrorraghia: 11, and residual trophoblastic tissue: 10. In the previous ultrasound, all indicated curettages for retained trophoblastic tissue showed it, and in a lower proportion those indicated for fever (66.6%) or methrorraghia (22.2%). A total of fourteen curettages (35%) were performed without suspect image of retained tissue, and in all cases the surgeon described to obtain small amount of tissue. From material submitted to pathologic evaluation trophoblastic tissue was found in 64.7%, and there were no differences as curettage indication.
  
  
  CONCLUSIONS
  When the previous ultrasound do not showed retained tissue, the surgeon did not remove retained material. When extracted there were always in small amounts. Therefore, it could be concluded that after cesarean section the curettage should be indicated only in the presence of evident ultrasound image of retained products.
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital Universitario ‘ 12 de Octubre’, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Almansa
authors.forename: Isabel
authors.initials: I
authors.lastname: Camaño
authors.forename: Olga
authors.initials: O
authors.lastname: Villar
authors.forename: Dolores
authors.initials: D
authors.lastname: Montañez
authors.forename: Paloma
authors.initials: P
authors.lastname: Vallejo
authors.forename: Antonio
authors.initials: A
authors.lastname: García-Burguillo
mesh_terms: D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D003475:Curettage / Q000379:methods*; D004716:Endometritis / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D018457:Placenta, Retained / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery; D049590:Postpartum Period; D011247:Pregnancy; D011644:Puerperal Disorders / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies