Randomized Trial Comparing Operative Hysteroscopy and Expectant Management for Removing Retained Products of Conception After Miscarriage in Women Aged 18 to 39 with Immediate Pregnancy Wish

What this Trial Is About

Researchers are studying women who have experienced a miscarriage and have remaining tissue inside the uterus, called retained products of conception RPOC, after non-surgical miscarriage management. The study aims to compare two approachesoperative hysteroscopy and expectant managementto see which leads to a quicker next pregnancy. This is a multicenter, randomized clinical trial involving women who wish to become pregnant within six months after miscarriage treatment and have evidence of RPOC six weeks after initial care. Participants are randomly assigned to one of two groups. One group receives operative hysteroscopy, a procedure using a special device to remove tissue from the uterus, usually performed within 2 to 3 weeks after randomization or after a repeat sonogram if needed. The other group receives expectant management, meaning no immediate treatment but monitoring, with emergency intervention only if severe symptoms occur. Both groups will be followed over time to assess outcomes. During the study, participants complete questionnaires about their quality of life at the start, 8 weeks, and 6 months after randomization. Researchers will track the time to the next pregnancy, pregnancy outcomes, any additional treatments or visits, complications, and health-related costs over up to three years. Safety and effectiveness of both approaches will be evaluated, with the total participation lasting up to three years from the start of the trial.

Removal of Intrauterine Retained Products of Conception (RPOC) After Miscarriage Guided by Hysteroscopy Trial. A Randomized Controlled Trial.