妊娠第2和第3个月医学终止妊娠后疑似保留胎盘的宫内手术相关因素

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction Pub Date : 2025-07-24 DOI:10.1016/j.jogoh.2025.103000

Annaëlle Amous , Célia Bettiol , Louise Paret Perinelli , Yann Tanguy Le Gac , Paul Guerby , Aurélie Buffeteau

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引用次数: 0

摘要

在妊娠中期和晚期医学终止妊娠（MTOP）的病例中，胎盘不完全排出是一种常见的并发症，通常导致宫内手术。对于MTOP引产后疑似残留胎盘的宫内手术相关因素的描述仍然很差。此外，这些手术可能导致各种并发症（子宫穿孔、感染、继发性出血、宫腔粘连、生育障碍）。本研究旨在确定这些因素，以支持更基于证据的宫内手术的使用。材料和方法：2019年1月1日至2021年12月31日在图卢兹大学医院进行了一项回顾性单中心研究。所有在妊娠14 - 41周间因MTOP接受引产的患者均被纳入研究。收集并分析产妇、产科和胎儿的特征。结果：共纳入371例患者。胎龄是唯一与疑似保留胎盘的宫内手术效果显著相关的因素(连续变量（aOR 0.84 [0.80-0.88], p < 0.0001），分类变量分为讨论：在第二和第三孕期确定与MTOP术后宫内手术相关的因素，可能导致基于胎龄的管理策略的修改，在本研究中，胎龄与22周以上进行宫内手术的可能性较低有关。结论：胎龄与MTOP术后疑似残留胎盘的宫内手术表现有关，超过22周的可能性较低。

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Factors associated with intrauterine procedure for suspected retained placenta after medical termination of pregnancy in the 2nd and 3rd trimesters

Introduction

In cases of medical termination of pregnancy (MTOP) in the second and third trimesters, incomplete placental expulsion is a common complication, often leading to intrauterine procedure. Factors associated with intrauterine procedure for suspected retained placenta after labor induction for MTOP remain poorly described. Moreover, these procedures may lead to various complications (uterine perforation, infections, secondary bleeding, intrauterine adhesions, fertility disorders). This study aims to identify these factors to support a more evidence-based use of intrauterine procedures.

Materials and Methods

A retrospective single-center study was conducted at Toulouse University Hospital, between January 1, 2019, and December 31, 2021. All patients who underwent labor induction for MTOP between 14 and 41 weeks of gestation were included. Maternal, obstetric, and fetal characteristics were collected and analyzed.

Results

A total of 371 patients were included. Gestational age was the only factor significantly associated with the performance of intrauterine procedures for suspected retained placenta (continuous variable (aOR 0.84 [0.80–0.88], p < 0.0001) and categorical variable divided into <22 weeks and ≥22 weeks of gestation (OR 0.15 [0.10–0.24], p < 0.001)).

Discussion

Identifying factors associated with intrauterine procedures after MTOP in the 2nd and 3rd trimesters could lead to modified management strategies, based on gestational age, which is associated in this study, with a lower likelihood of performing intrauterine procedures beyond 22 weeks.

Conclusion

Gestational age was associated with the performance of intrauterine procedures for suspected retained placenta after MTOP, with a lower likelihood beyond 22 weeks of gestation.

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来源期刊

Journal of gynecology obstetrics and human reproduction Medicine-Obstetrics and Gynecology

CiteScore

3.70

自引率

5.30%

发文量

210

审稿时长

31 days

期刊介绍： Formerly known as Journal de Gynécologie Obstétrique et Biologie de la Reproduction, Journal of Gynecology Obstetrics and Human Reproduction is the official Academic publication of the French College of Obstetricians and Gynecologists (Collège National des Gynécologues et Obstétriciens Français / CNGOF). J Gynecol Obstet Hum Reprod publishes monthly, in English, research papers and techniques in the fields of Gynecology, Obstetrics, Neonatology and Human Reproduction: (guest) editorials, original articles, reviews, updates, technical notes, case reports, letters to the editor and guidelines. Original works include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses.