Hysteroscopy Versus Endouterine Aspiration in Managing Trophoblastic Retention After Early Miscarriage: A Prospective Randomized Multicenter Study

What this Trial Is About

Researchers are studying treatment options for women experiencing incomplete early miscarriage, where some pregnancy tissue remains in the uterus after an early miscarriage. This condition can cause ongoing bleeding and infection, increasing distress for patients. The study aims to compare two surgical methods, hysteroscopy and endo-uterine aspiration, to see which is more effective at clearing retained tissue six weeks after surgery, using ultrasound for evaluation. Participants will be randomly assigned to one of two groups: one receiving operative hysteroscopy performed by a gynecologic surgeon under anesthesia, and the other undergoing endo-uterine aspiration using a cannula. Both groups may receive misoprostol and antibiotic prophylaxis before surgery, and anti-adhesion gels may be applied to reduce scarring. Additional care includes treatment for infections if needed and preventative care for Rh-negative women. The study involves multiple centers and standardized protocols. Participants will have a pre-operative consultation for eligibility and consent, followed by surgery on the assigned day. Follow-up includes a six-week post-surgery visit with ultrasound and hysterosonography to check uterine emptiness and scar tissue, plus phone consultations at 6, 12, and 24 months to assess fertility and time to conception. Researchers will monitor complications, need for additional surgery, and pregnancy outcomes over two years. The total participation may last up to 26 months after surgery.

Hysteroscopy vs. Endouterine Aspiration in the Management of Trophoblastic Retention