MANAGING RESIDUAL TROPHOBLASTIC TISSUE - HYSTEROSCOPY FOR DIRECTING CURETTAGE

OBJECTIVE: To describe our experience with selective removal of residu al intrauterine trophoblastic tissue via hysteroscopy. METHODS: This i s a descriptive report. Eighteen patients, 16 postabortion and 2 postp artum, underwent a hysteroscopic procedure for removal of residual tro phoblastic tissue causing continuous bleeding. At hysteroscopy, a cutt ing loop seas used as a curette for selective removal of the adherent residual tissue, while interference with the rest of the endometrial s urface was avoided. RESULTS: Complete removal of the suspected residua l tissue was achieved in all patients. Histology confirmed the curetti ngs as trophoblastic remnants. No complications were reported during o r immediately after the procedure. The median operative time was 10 mi nutes (range, 8-20). In all cases the bleeding stopped shortly after t he procedure. In each patient, postoperative ultrasonography revealed a uterine cavity free of residual tissue. Five of the patients underwe nt second-look hysteroscopy several weeks Inter, and no signs of furth er residual tissue were observed. CONCLUSION: Selective curettage of r esidual trophoblastic tissue directed by hysteroscopy is an easy and s hort procedure and might be preferable to conventional, nonselective, blind curettage.