Poster Session

P365. mbulatory Hysteroscopy for Retained Products of Conception following first trimester medical abortion

Tanvir Tanvir (IN)

[Tanvir] Tanvir Hospital

– Objective : To determine the safety, feasibility, acceptability and cost effectiveness of using operative ambulatory hysteroscopy to remove retained products of conception following first trimester medical abortion – Methods Design : Prospective study Setting : Private Hospital Based Study – Patient(s) : All women treated by office hysteroscopy for retained products of contraception following first trimester medical abortion with Tab mifepristone 200 mg - Tab misoprostol 800 ug protocol for medical termination of pregnancy from March 2017 to October 2017. – Intervention(s) : Office Operative Hysteroscopy using 5 Fr mechanical instruments was executed to excise and remove retained products of conception. No sedatives or analgesic was used before, during or after the procedure. – Main Outcome Measure(s) : Patient’s acceptability is high as office hysteroscopy allows for a same-day “see and treat” approach. Time taken to perform hysteroscopic removal of retained products is lower in comparison to D & C under anaesthesia and is cost effective. – Result(s) : 15 patients were studied. The Pain scale (VAS) was between 0 - 4. According to Likert scale, the patient satisfaction varied from satisfied to very satisfied. The mean time from medical termination to operative hysteroscopy was 27 +/- 3 days.There were no intraoperative complications. Follow up ultrasound at 6 - 8 weeks did not reveal any evidence of intrauterine adhesions. The cost effectiveness of the procedures over the traditional dilatation and curettage under general anaesthesia was found to be better in the office hysteroscopy group as the need for operation theatre, gowns, personnel and any form of anaesthesia was eliminated. – Conclusions : Ambulatory hysteroscopy with mechanical removal of retained products is possible without any form of anaesthesia and negligible complications. Enables women’s involvement with great level of satisfaction in terms of pain, time spent, immediate ambulation and cost effectiveness. Keywords : Office Hysteroscopy, retained products of conception, cost effective