Conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy.

OBJECTIVE To analyse the results of our conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy and to describe our experience and guidelines. STUDY DESIGN Descriptive retrospective study. Eighty-four women with suspected retained trophoblastic tissue after pregnancy underwent hysteroscopic examination and extraction of all residual tissue in the office under direct visualization of the uterine cavity, without anaesthesia or cervical dilatation. RESULTS Hysteroscopic examination was tolerated by all but one patient. In 82 cases (97.4%), the diagnosis after hysteroscopic examination was placental polyp or retained trophoblastic tissue. This diagnosis was histologically confirmed in 79 cases (94.7%). In 43.6% (36) of the cases, complete evacuation of the uterine cavity was achieved during a single hysteroscopic examination. The only complication after hysteroscopy was one case of major vaginal bleeding requiring curettage. CONCLUSIONS Diagnostic-operative ambulatory hysteroscopy is a suitable alternative to blind curettage in the management of retained trophoblastic tissue. This technique can be performed in the office without anaesthesia and with a low rate of complications.