Adiel Cohen, Gilad Karavani, Amit Zamir, Ayalon Hadar, Henry H Chill, Avraham Zini
{"title":"在对头胎流产失误进行扩张和刮宫术时使用超声引导是否能降低并发症发生率?","authors":"Adiel Cohen, Gilad Karavani, Amit Zamir, Ayalon Hadar, Henry H Chill, Avraham Zini","doi":"10.23736/S2724-606X.22.05192-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Dilation and curettage (D&C) may be performed with or without transabdominal ultrasound guidance. The aim of this study was to evaluate the association between the use of ultrasound guidance during D&C for first trimester missed abortion (MA) and D&C related complication rates.</p><p><strong>Methods: </strong>A retrospective cohort study included women in the age of 20-45 years, who underwent D&C for first-trimester MA in a hospital-based setting between 2013-2019. The study population was divided into two groups: the study group which included women who underwent D&C with ultrasound guidance (US group) and the control group, which included women who underwent D&C without ultrasound guidance (N-US group). Gynecologic, obstetric, and operative related data were collected from electronic medical records.</p><p><strong>Results: </strong>Three-hundred and seventy-eight women were included in the study, 86 women in the US group and 292 women in N-US group. Baseline maternal characteristics and procedure-related characteristics did not differ between the groups. No significant difference between the US group and N-US group was shown when comparing D&C related complications, including retained products of conception rate (2.3% vs. 5.5%, respectively; P=0.385), uterine perforation rate (1.2% vs. 0.3%, respectively; P=0.404), and the total complication rate (8.1% vs. 12.3%, respectively; P=0.338). In a multivariate analysis, the use of ultrasound guidance during D&C was not found to be associated with lower complication rate (adjusted odds ratio [aOR] 95% confidence interval [CI] 1.468 [0.578-3.729], P=0.419).</p><p><strong>Conclusions: </strong>Performance of D&C under ultrasound guidance for first-trimester MA, in a hospital-based setting, was not associated with lower complication rate, suggesting that the common practice of performing D&C without the use of ultrasound is an acceptable approach.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Does ultrasound guidance during dilation and curettage for first trimester missed abortion reduce complication rates?\",\"authors\":\"Adiel Cohen, Gilad Karavani, Amit Zamir, Ayalon Hadar, Henry H Chill, Avraham Zini\",\"doi\":\"10.23736/S2724-606X.22.05192-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Dilation and curettage (D&C) may be performed with or without transabdominal ultrasound guidance. The aim of this study was to evaluate the association between the use of ultrasound guidance during D&C for first trimester missed abortion (MA) and D&C related complication rates.</p><p><strong>Methods: </strong>A retrospective cohort study included women in the age of 20-45 years, who underwent D&C for first-trimester MA in a hospital-based setting between 2013-2019. The study population was divided into two groups: the study group which included women who underwent D&C with ultrasound guidance (US group) and the control group, which included women who underwent D&C without ultrasound guidance (N-US group). Gynecologic, obstetric, and operative related data were collected from electronic medical records.</p><p><strong>Results: </strong>Three-hundred and seventy-eight women were included in the study, 86 women in the US group and 292 women in N-US group. Baseline maternal characteristics and procedure-related characteristics did not differ between the groups. No significant difference between the US group and N-US group was shown when comparing D&C related complications, including retained products of conception rate (2.3% vs. 5.5%, respectively; P=0.385), uterine perforation rate (1.2% vs. 0.3%, respectively; P=0.404), and the total complication rate (8.1% vs. 12.3%, respectively; P=0.338). In a multivariate analysis, the use of ultrasound guidance during D&C was not found to be associated with lower complication rate (adjusted odds ratio [aOR] 95% confidence interval [CI] 1.468 [0.578-3.729], P=0.419).</p><p><strong>Conclusions: </strong>Performance of D&C under ultrasound guidance for first-trimester MA, in a hospital-based setting, was not associated with lower complication rate, suggesting that the common practice of performing D&C without the use of ultrasound is an acceptable approach.</p>\",\"PeriodicalId\":18572,\"journal\":{\"name\":\"Minerva obstetrics and gynecology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Minerva obstetrics and gynecology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.23736/S2724-606X.22.05192-2\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/11/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minerva obstetrics and gynecology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.23736/S2724-606X.22.05192-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/11/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Does ultrasound guidance during dilation and curettage for first trimester missed abortion reduce complication rates?
Background: Dilation and curettage (D&C) may be performed with or without transabdominal ultrasound guidance. The aim of this study was to evaluate the association between the use of ultrasound guidance during D&C for first trimester missed abortion (MA) and D&C related complication rates.
Methods: A retrospective cohort study included women in the age of 20-45 years, who underwent D&C for first-trimester MA in a hospital-based setting between 2013-2019. The study population was divided into two groups: the study group which included women who underwent D&C with ultrasound guidance (US group) and the control group, which included women who underwent D&C without ultrasound guidance (N-US group). Gynecologic, obstetric, and operative related data were collected from electronic medical records.
Results: Three-hundred and seventy-eight women were included in the study, 86 women in the US group and 292 women in N-US group. Baseline maternal characteristics and procedure-related characteristics did not differ between the groups. No significant difference between the US group and N-US group was shown when comparing D&C related complications, including retained products of conception rate (2.3% vs. 5.5%, respectively; P=0.385), uterine perforation rate (1.2% vs. 0.3%, respectively; P=0.404), and the total complication rate (8.1% vs. 12.3%, respectively; P=0.338). In a multivariate analysis, the use of ultrasound guidance during D&C was not found to be associated with lower complication rate (adjusted odds ratio [aOR] 95% confidence interval [CI] 1.468 [0.578-3.729], P=0.419).
Conclusions: Performance of D&C under ultrasound guidance for first-trimester MA, in a hospital-based setting, was not associated with lower complication rate, suggesting that the common practice of performing D&C without the use of ultrasound is an acceptable approach.