关键词: Incomplete abortion combined oral contraceptives medical management retained products of conception

Mesh : Abortion, Incomplete / drug therapy epidemiology etiology Abortion, Induced / adverse effects methods statistics & numerical data Abortion, Spontaneous / drug therapy surgery Adult Choice Behavior Contraceptives, Oral, Combined / therapeutic use Desogestrel / therapeutic use Dilatation and Curettage Ethinyl Estradiol / therapeutic use Female Humans Misoprostol / therapeutic use Pilot Projects Pregnancy Pregnancy Trimester, First Retrospective Studies Tablets Treatment Failure Uterine Hemorrhage / drug therapy epidemiology etiology surgery

来  源:   DOI:10.1080/09513590.2018.1427714

Abstract:
Many Patients with persistent retained products of conception prefers to avoid surgical interventions, such as a dilatation and curettage (D&C) that might pose an additional future risk to their already compromised fertility or obstetric performance. The aim of this study was to the possibility of induced withdrawal bleeding following oral contraceptive administration as a non-surgical treatment for patients with persistent retained products of conception (RPOC). A retrospective study of patients presenting with retained products of conception (RPOC) after failed expectant management or after treatment with PGE1 was performed. Twelve women presenting with RPOC at ≤8 weeks gestation with minimal to mild vaginal bleeding and no signs of infection were treated with oral contraceptive pill (OCP) containing 0.03 mg ethinylestradiol and 0.15 mg of desogestrel for 3 weeks. Out of the 12 patients treated, nine women (75%) successfully expelled the RPOC after completing the three-week course of OCPs. The three cases (25%) that did not resolve following OCP treatment had pregnancy products with positive blood flow on Doppler examination. We conclude that OCPs may be a useful medical treatment option for persisting RPOC in selected patients with absence blood flow on Doppler examination wishing to avoid surgical intervention.
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