Afolabi, Adenike (2020) Treatment of patients with an incomplete evacuation after the initial treatment of abortion. Damnum occultatum. thesis, Medicine.
Full text available on request.Abstract
Study objective: an evaluation of treatment for incomplete evacuation of the uterus after initial treatment for a first trimester miscarriage, in the ISALA hospital Zwolle, Netherlands. In addition, determining the difference in efficacy between treatment options for an incomplete evacuation of the uterus: expectant management vs misoprostol vs misoprostol in combination with mifepristone vs curettage vs hysteroscopy guided surgery. Design: a retrospective cohort study. Measurements and main results: The primary outcome was re-intervention rate. The number of patients that needed a re-intervention after treatment of the incomplete evacuation of the uterus. Re-intervention rate was also the determinant of efficacy. The secondary outcomes were short term complications, long term complications and pregnancy outcomes. Data was collected between 2014 and June 2020, in which a total of 421 patients were found to have an incomplete evacuation of uterus after initial treatment for a first trimester miscarriage. In the group of patients that received expectant management for treatment of the incomplete evacuation of the uterus, 19 out of 54 patients (35.1%) needed a re-intervention. In the misoprostol group 75 out of 101 patients (74.2%) needed re-intervention, in the misoprostol and mifepristone group 41 out of 62 patients (66.1%) needed re-intervention, in the group that received curettage that was 10 out of 128 patients (7.8%) and lastly in the hysteroscopy guided technique group 2 out of 76 patients (2.6%) needed re-intervention (p=.00). Conclusion: the most effective treatment option for an incomplete evacuation of the uterus was hysteroscopy guided surgery, however expectant management was also an effective and safe option.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dijkstra, Drs. JR |
| Faculty: | Medical Sciences |
| Date Deposited: | 24 Jul 2023 11:05 |
| Last Modified: | 24 Jul 2023 11:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3596 |
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