Comparing Hysteroscopy and Endouterine Aspiration to Treat Trophoblastic Retention After Early Miscarriage in Women Aged 18 to 42

What this Trial Is About

Researchers are studying management options for incomplete early miscarriage, a condition where pregnancy tissue remains in the uterus after miscarriage, causing symptoms like bleeding and inflammation. This study compares two surgical approachesoperative hysteroscopy and endo-uterine aspirationto see which is more effective in clearing retained tissue six weeks after surgery. The trial also looks at complication rates, need for additional surgery, uterine scarring, and fertility outcomes up to two years after the procedure. Participants are randomly assigned to one of two groups one receiving operative hysteroscopy, where a surgeon removes retained tissue using a camera and specialized instruments, and the other receiving endo-uterine aspiration, where tissue is suctioned out using a flexible or rigid cannula. Both groups receive standard care such as antibiotic prophylaxis before surgery and measures to prevent uterine adhesions. Women Rh-negative receive preventative treatment against Rh sensitization. The procedures occur on the day of surgery with follow-up visits scheduled at 6 weeks, 6 months, 12 months, and 24 months after surgery. During the study, participants undergo a pre-operative consultation, surgical treatment, and multiple follow-up assessments including ultrasounds, hysterosonography scans, blood tests to rule out pregnancy, and questionnaires about fertility and conception times. Researchers monitor complications, uterine vacancy, scarring, and pregnancy outcomes. The study lasts up to two years after surgery, with telephone follow-ups to evaluate fertility and conception progress. The main outcome is uterine emptiness six weeks post-surgery, measured by endovaginal ultrasound.

Hysteroscopy vs. Endouterine Aspiration in the Management of Trophoblastic Retention