title: Reproductive Outcomes After Hysteroscopic Resection of Retained Products of Conception.
abstract: To characterize pregnancy outcomes after hysteroscopic resection of retained products of conception (RPOCs), especially as it relates to abnormal placentation.
  
  
  
  Retrospective cohort study (Canadian Task Force classification II-2).
  
  
  
  Academic medical center.
  
  
  
  All women who underwent hysteroscopic resection of RPOCs at Northwestern Prentice Women's Hospital between January 2004 and December 2014.
  
  
  
  Hysteroscopic resection of RPOCs.
  
  
  
  The medical records of all cases of hysteroscopic resection of RPOCs between January 2004 and December 2014 were reviewed. Demographic characteristics, operative findings, surgical procedure, surgical pathology, and pregnancy outcomes for preceding and subsequent pregnancies were obtained. Our primary outcome was abnormal placentation in the pregnancy after the procedure. There were a total of 55 subsequent pregnancies and 38 live births. Among these pregnancies, 54.5% (30/55) were vaginal deliveries, 34.5% (19/55) were cesarean deliveries, and 7.3% (4/55) were early pregnancy losses. Abnormal placentation was present in 18.1% of subsequent pregnancies (10/55). This consisted of 3 patients with placenta previa, 2 with placenta accreta, and 5 with retained placenta.
  
  
  
  Women who undergo hysteroscopic resection of RPOCs have a higher rate of abnormal placentation in subsequent pregnancies when compared with the general population. Although the etiology is likely multifactorial, the underlying pathology leading to the initial diagnosis of RPOCs is believed to play a major role.
authors.affiliation: Department of Obstetrics and Gynecology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Ikhena
authors.affiliation: Department of Obstetrics and Gynecology and Reproductive Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Pietro
authors.initials: P
authors.lastname: Bortoletto
authors.affiliation: Department of Obstetrics and Gynecology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Angela K
authors.initials: AK
authors.lastname: Lawson
authors.affiliation: Department of Obstetrics and Gynecology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Rafael
authors.initials: R
authors.lastname: Confino
authors.affiliation: Department of Obstetrics and Gynecology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Erica E
authors.initials: EE
authors.lastname: Marsh
authors.affiliation: Department of Obstetrics and Gynecology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Magdy P
authors.initials: MP
authors.lastname: Milad
authors.affiliation: Department of Obstetrics and Gynecology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Marissa L
authors.initials: ML
authors.lastname: Steinberg
authors.affiliation: Department of Obstetrics and Gynecology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Edmond
authors.initials: E
authors.lastname: Confino
authors.affiliation: Department of Obstetrics and Gynecology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: m-pavone@northwestern.edu.
authors.forename: Mary Ellen G
authors.initials: ME
authors.lastname: Pavone
mesh_terms: D000328:Adult; D002170:Canada; D015331:Cohort Studies; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D008499:Medical Records; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D059351:Organ Sparing Treatments; D018457:Placenta, Retained / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult
keywords: Abnormal placentation; Hysteroscopy; Retained products of conception