Intrauterine adhesions after conservative and surgical management of spontaneous abortion

Abstract

Study objective: To determine the frequency of intrauterine adhesions (IUA) after conservative management, medical evacuation, and surgical evacuation for spontaneous abortion.

Design: Prospective follow-up study (Canadian Task Force classification II-2).

Setting: Gynecology unit in a teaching hospital.

Patients: Eighty-two women who had been treated with conservative management, medical evacuation, or surgical evacuation of retained products of conception after spontaneous abortions in a randomized, controlled trial.

Measurements and main results: Hysteroscopic diagnosis of IUA 6 months after initial treatment was the primary outcome measure. No cases of IUA were found in patients managed conservatively or by medical evacuation, whereas two cases (7.7%) of filmy IUA were detected in those managed by surgical evacuation. There was no statistical significant difference in the rate of self-reported reduced menstrual flow 6 months after initial treatment by any method.

Conclusion: The prevalence of IUA was low after each modality of treatment for spontaneous abortion. Conservative management and medical evacuation are both acceptable alternatives to standard surgical evacuation.