Clinical value of transcervical resection under hysteroscope for placental remnants

Objective To study the clinical value of transcervical resection under hysteroscope in treatment of placental remnants.Methods From March 2003 to April 2006,14 cases of placental remnants were treated with transcervical resection under hysteroscope.They included 3 cases of term birth,and 11 cases of midtrimester induction of labor.Drug pretreatment was performed for those who had more than 80 U/L of blood beta-human chorionic gonadotropin (β-hCG) level,including mifepristone (RU486), Chinese herbs and methotrexate(MTX).RU486 was taken orally at 25 mg,three times daily and misoprostol was given 600 μg at one dose on the third day.MTX was given by deep intramuscular injection at 1 mg/m~2 if β-hCG was higher than 150 U/L.Bipolar evaporation was used in the operation with alternation of resection and forceps holder under ultrasonographic supervision.After operation a circular contraceptive device was placed followed by hormone periodic treatment such as estradiol valerate for 2-4 months.Results Under the monitoring by ultrasonography,14 operations were all performed smoothly.The follow-up was from 6 months to 2 years.Menstruations in almost all the cases were recovered,and 3 cases of those were pregnant and delivered smoothly 4,6 and 7 months after operation.Conclusion The transcervical resection under hysteroscope is useful in treatment of placental remnants with obvious effects,little trauma and few complications.