ABSTRACT
Background: Surgical evacuation of the uterus is one of the treatment options for a missed miscarriage. Usually, the decision to perform surgery is mostly based on clinical grounds
Objective: To evaluate the patient's clinical presentation on Evacuation of Retained Products of Conception [ERPC]. Design: A Retrospective Study. Setting: Gynecology and Obstetrics Department, Bahrain Defense Force Hospital, Bahrain
Method: All missed miscarriage cases from 1 December 2013 to 21 December 2014 were included in the study. The management of missed miscarriage was divided into group A and group B, based on the need for ERPC. Factors such as history of previous miscarriage ERPC, pain/bleeding, and cervical opening were evaluated. Data were analyzed using Stats Direct. P-value of < 0.05 was considered statistically significant
Result: One thousand five hundred patients with confirmed miscarriage were included in the study; 91 [6%] were missed miscarriage and 49 [54%] of those required ERPC. The study groups had similar personal characteristics. Patients who had a previous history of miscarriage were less likely to have ERPC. Having a history of ERPC did not increase the risk of repeat procedure. Patients who presented with abdominal pain and bleeding were significantly more likely to have ERPC. Cervical assessment on admission had no role in the decision to perform surgery
Conclusion: ERPC accounted for more than 50% of our management of missed miscarriages. We found a higher rate of surgical management in patients who presented with pain and bleeding
ABSTRACT
Ovarian pregnancy is a rare type of ectopic pregnancy. We report an ovarian ectopic pregnancy at the right ovary. A thirty-eight year old woman presented with amenorrhea for six weeks and lower abdominal pain. Beta-human chorionic gonadotropin [BHCG] was 2290 IU. Imaging revealed a mass at the right adnexa about 3x2.5 cm and blood clots were adherent to the uterus. The mass was removed through emergency laparoscopy. Pathology revealed ovarian pregnancy. Serial monitoring of BHCG level to confirm the complete removal of placental tissue was done