Intraoperative Ultrasound Guidance During Curettage After Second-Trimester Delivery is Associated With a Higher Rate of Complications.
J Obstet Gynaecol Can
; 42(9): 1080-1085, 2020 Sep.
Article
en En
| MEDLINE
| ID: mdl-32345554
ABSTRACT
OBJECTIVE:
The use of intraoperative ultrasound guidance for second-trimester elective dilation and curettage reduces the incidence of uterine perforation. However, the role of intraoperative ultrasound guidance during curettage following second-trimester delivery has not been evaluated. We aim to evaluate the effect of intraoperative ultrasound guidance during curettage following second-trimester delivery.METHODS:
We conducted a retrospective cohort study that included patients who had a second-trimester delivery at up to 236/7 weeks gestation and underwent uterine curettage after the fetus was delivered.RESULTS:
Overall, 273 patients were included. Of them, 194 (71%) underwent curettage without intraoperative ultrasound guidance, while 79 (29%) underwent the procedure utilizing intraoperative ultrasound guidance. The overall rate of a composite adverse outcome was higher among those undergoing curettage under intraoperative ultrasound guidance compared with no ultrasound guidance (31 [39.2%] vs. 40 [20.6%]; OR 2.4; 95% CI 1.4-4.4, Pâ¯=â¯0.002). Placental morbidity (10 [12.6%] vs. 11 [5.6%]; OR 1.9; 95% CI 1.01-5.9, Pâ¯=â¯0.04) and infectious complications (6 [7.5%] vs. 5 [2.5%]; OR 3.1; 95% CI 1.01-10.4, Pâ¯=â¯0.05) were more frequent among those undergoing curettage with intraoperative ultrasound guidance. In a multivariate logistic regression analysis, intraoperative ultrasound guidance was the only independent factor positively associated with the occurrence of an adverse outcome (adjusted OR 1.93; 95% CI 1.1-3.4, Pâ¯=â¯0.02). Procedure time was longer when ultrasound guidance was used (952 vs. 658 mins; P < 0.001).CONCLUSION:
Intraoperative ultrasound guidance during curettage after second-trimester delivery is associated with a higher complication rate than no guidance.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Perforación Uterina
/
Rotura Uterina
/
Ultrasonografía
/
Aborto Inducido
/
Dilatación y Legrado Uterino
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
J Obstet Gynaecol Can
Asunto de la revista:
GINECOLOGIA
/
OBSTETRICIA
Año:
2020
Tipo del documento:
Article