(1034) Impact of Timing of Hysteroscopy for Retained Products of Conception on Subsequent Pregnancy Outcomes

Objective: Retained products of conception (RPOC) occur in ~3% of deliveries and can have significant adverse effects on women's health. Hysteroscopy removes RPOC but has its own possible side effects. On the other hand,delayed treatment may damage the endometrium. Prolonged RPOC can lead to infection and inflammation, potentially affects future pregnancy outcomes. We studied outcomes for women with suspected RPOC, comparing hysteroscopy performed within 8 weeks versus more than 8 weeks postpartum.

Study Design: Our 2010-2023 retrospective dataset included information on women who had suspected RPOC and who underwent hysteroscopy at a tertiary medical health center. Women with a documented subsequent live birth following hysteroscopy were categorized based on timing: Group 1 (hysteroscopy within 8 weeks) and Group 2 (hysteroscopy beyond 8 weeks). We compared maternal characteristics, hysteroscopic findings, subsequent delivery details and neonatal outcomes between the two groups. The primary outcome was gestational age at delivery for the subsequent pregnancy. Secondary outcomes included various maternal and neonatal complications.

Results: Both groups had similar baseline characteristics. There were no significant differences in most aspects of the first delivery course, including mode of delivery. Indications for hysteroscopy were similar between groups, with retained placental tissue being the most common finding.

Regarding subsequent pregnancies following hysteroscopy, time to conception, gestational age at delivery, pregnancy complications including hypertensive disease, and most delivery outcomes were all similar between the two groups. Neonatal outcomes were also comparable.

Conclusion: The timing of hysteroscopy for RPOC following delivery - whether within 8 weeks or more than 8 weeks postpartum - appears to have minimal impact on subsequent pregnancy outcomes. Therefore, a wait-and-see approach might be recommended at least for two months after delivery. However, further investigation with a larger sample size is needed to confirm these findings.