Uterine preservation surgery for placental polyp.
OBJECTIVE
To examine clinical and surgical performances of cases with placental polyps in which uterine preservation surgery was conducted.


METHODS
During the period September 2002 to April 2009, we examined eight cases (hysteroscopic resection, six cases; laparotomy, one case; dilatation and curettage, one case) diagnosed with placental polyp that had been treated with polyp extraction surgery. Imaging evaluation was done using magnetic resonance imaging and 2-D ultrasound.


RESULTS
Three of the eight cases (37.5%) had been first-time pregnancies. Most of our cases experienced minimal surgical manipulation after medical abortion. Among them, six cases (75%) were mid-term medical abortions, one case (12.5%) received no treatment after spontaneous abortion, and one case (12.5%) had postsurgical abortion (dilatation and curettage). All cases showed variable amount of blood flow in the internal mass and myometrium by color Doppler ultrasound. Magnetic resonance imaging angiography showed contrast effects in the intrauterine cavity and myometrium in selected cases. The average duration from diagnosis to surgery was 32 days (range, 11-105). Color Doppler revealed a reduction in blood flow in five cases during the waiting period until surgery with an average blood loss of 10 g (range, 0-20) during surgery.


CONCLUSIONS
Use of color Doppler ultrasound may be useful in diagnosing placental polyp. Although hysteroscopic resection of placental polyp is effective in patients hoping for uterine preservation, delaying timing of surgery may reduce blood loss during operative procedure.
Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Koichi
K
Hiraki
Khaleque Newaz
KN
Khan
Michio
M
Kitajima
Akira
A
Fujishita
Hideaki
H
Masuzaki
D000022:Abortion, Spontaneous / Q000209:etiology; D000032:Abortion, Therapeutic / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004107:Dilatation and Curettage / Q000009:adverse effects; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D007564:Japan; D059351:Organ Sparing Treatments; D010922:Placenta Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011127:Polyps / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D061665:Time-to-Treatment; D000267:Tissue Adhesions / Q000517:prevention & control; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
color Doppler; delayed surgery; hysteroscopic resection; medical abortion; placental polyp