Retained Product of Pregnancy Clinical Trial
Official title:
The Correlation Between Clinical Diagnosis of Retained Placenta And Histology
The main purpose is to evaluate the correlation in qualitative and quantitative manner between clinical diagnosis of retained placenta and histology. Secondly, to assess different clinical parameters that are likely related to accuracy of the diagnosis of RPOC
Background:
Retained products of conception (RPOC) are a common and treatable complication after delivery
or termination of pregnancy. The reported incidence in the literature is around 1% of all
pregnancies. Most often, diagnoses are made on clinical basis and there is only scarce
information available related to the correlation between the clinical and pathological
diagnosis of RPOC. The gold standard for diagnosis of RPOC is based on histopathological
confirmation of chorionic villi in tissue derived from the uterus. Once RPOC is diagnosed on
a clinical basis, several treatment options are available, including expectant management,
pharmacological treatment, and surgical interventions. Given the risks associated with
surgical interventions, accurate diagnosis is vital. Guidelines at Maccabi Health Care
Organization mandate that hysteroscopic removal of suspected RPOC should be performed only
after approval by a Gynecological Surgical Preauthorization committee. Based on the activity
of this committee and starting 2011, Maccabi has developed a database on certain
gynecologic-surgical procedures including hysteroscopic removal of suspected RPOC.
Purpose of the study:
The main purpose is to evaluate the correlation in qualitative and quantitative manner
between clinical diagnosis of retained placenta and histology.
Expected results:
70% correlation between the clinical and pathological diagnosis of RPOC.
Methods:
Establishing a dedicated database which includes demographic, clinical and histological data
of women who have undergone hysteroscopic removal of suspected RPOC and statistical
assessment of correlations.
Significance:
Determination of the correlation between clinical suspicion and histological diagnosis of
retained placental tissue Finding clinical parameters that may increase the accuracy of this
diagnosis and will help to prevent unnecessary procedures.
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