SUCCESSFUL HYSTEROSCOPY GUIDED SUCTION & EVACUATION OF PRODUCT OF CONCEPTION ALONG WITH REMOVAL OF UTERINE SEPTUM IN SAME SITTING

ABSTRACT

Objective To report a case of early pregnancy loss with septate uterus, successfully managed by hysteroscopy guided suction & evacuation of product of conception along with removal of uterine septum in same sitting. Case report. Tertiary care hospital. One woman with early pregnancy loss with septate Design Setting Patient uterus. Hysteroscopy guided suction & evacuation of product of conception along with removal of uterine septum Intervention in same sitting. Hysteroscopy guided suction & evacuation of product of conception followed by septum removal with Result hysteroscopic scissor was performed, with minimal blood loss, in same sitting. Products of conception were sent for pathologic examination. There were no intra-operative or postoperative complications. Even though the role of septum as a Conclusion contributing factor to miscarriage in not certain, early pregnancy loss may be seen in patients with septate uterus. Blind removal of POCs with dilatation & curettage, may be complicated with retained products of conception (RPOC) or intrauterine adhesion formation, which can lead to adverse fertility outcomes in the future. Also removal of septum, which may or may not be the cause, is often performed before further pregnancy. This requires another admission & exposure to anaesthesia, along with added cost. Hysteroscopy guided resection of POC with septum removal in same sitting has been associated with complete tissue removal under vision, less damage to surrounding endometrium, cost effective combination of two surgical procedures & earlier time to conception compared with 2 sitting procedure (dilation and curettage than septum removal). Thus, hysteroscopy guided suction & evacuation of POC & septum removal in same sitting can be considered as an alternative surgical technique for management of early pregnancy loss in patients diagnosed with septate uterus. This case report demonstrates the successful application of hysteroscopic procedure in a case of early pregnancy loss with septate uterus.