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| Efficacy of hysteroscopic surgery combined with progynova and mifepristone for treating patients with intrauterine pregnancy residual |
| The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian Province, 361000 |
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Abstract To investigate the efficacy of hysteroscopic surgery combined with progynova and mifepristone for treating patients with intrauterine pregnancy residual (IPR). Methods: The clinical data of 65 patients with IPR from January 2020 to December 2021 were collected retrospectively. These patients were divided into two groups according to the difference of surgical methods. 32 patients in group A had been give uterine aspiration guided by ultrasound combined with progynova and mifepristone. 33 patients in group B were treated with hysteroscopic curettage combined with progynova and mifepristone. The surgical indicators, the postoperative recovery situation, the blood human chorionic gonadotropin (HCG) level, the complications rate, the cure rate, and the reintervention rate of the patients were compared between the two groups. Results: The operation duration (10.1±2.5 min) and intraoperative blood loss (8.3±2.5 ml) of the patients in group B were significantly shorter than those of the patients in group A. The time to stop postoperative bleeding (8.8±1.2d) of the patients in group B was significantly shorter than that (8.8±1.2d) of the patients in group A. The time of menstruation recovery (26.4±5.1d) and the time of blood HCG turned to negative (10.5±3.4d) of the patients in group B were significantly lower than those (34.4±5.8d and 14.3±3.7d) of the patients in group A. The different level of blood HCG between 1 day after operation and before operation of the patients in group B (441.01±22.47 IU/ml) was significantly more than that (367.29±26.75 IU/ml) of the patients in group A. The incidences of postoperative intrauterine adhesion (0) and total complication rate (3.0%) of the patients in group B were significantly lower than those (18.8% and 25.0%) of the patients in group A. The cure rate (100.0%) of the patients in group B was significantly higher than that (75.0%) of the patients in group A, and the reintervention rate (0) of the patients in group B was significantly lower than that (25.0%) of the patients in group A (all P＜0.05). Conclusion: Hysteroscopic curettage combined with progynova and mifepristone for treating the patients with IPR can shorten the operation time, reduce the intraoperative bleeding, promote the postoperative recovery, decrease the incidences of postoperative intrauterine adhesions again and the reintervention, and can improve the cure rate, with less complications.
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