The Meta-analysis Of The Efficiency And Complications Of Expectant Treatment Versus Curettage Management Of Retained Products Of Conception

Objective:Retained Products of Conception(RPOC)could occurs in any women who had a termination of pregnancy of any gestational age,it goes with one percent after birth and more with early pregnancy failure or artificial abortion,the incidence got higher to 2.3%-21.3% in China with those labor induction at second trimester.D&C as a traditional treatment of RPOC goes with lots of complications and repeated curettage leads to raise incidence of intrauterine adhesion(IUA)which cause bad affect on fertility.The medical and expectant treatment make multiple therapy.This paper are going to Meta-analysis the expectant treatment versus curettage with there effect and complications.At the mean time discussing effectiveness and safety of estrogen and progesterone treatment to draw attention of medical workers to reduce unnecessary curettage to lower incidence of IUA.The aim of this meta-analysis is to examine the current evidence regarding to the expectant treatment versus curettage and make further discussion about the point of conservative treatment towards RPOC.Method: A literature search was conducted using Medline、cochranelibrary,clinical trail,EMBASE,PROSPERO,google scholar,WANFANG data,VIP data and CNKI.We collected those papers of expectant treatment versus curettage according to the selected criteria,making meta-analysis using the application RevMan 5.2Results: There’s 9 study intake with 1335 patients,include 717 women who toke expectant while 618 toke curettage.There is statistic difference with number pf success cases,but those who underwent expectant treatment go with less infection and IUA,while the number of emergency evacuation equals between two sets.Conclusion: Expectant treatment is effective,though a little weaker than curettage,with less infection and Intrauterine adhesion when deal with RPOC.Especially for those residual diameter varies from 15 to 50 mm expectant treatment woks well enough to replace large percent of curettage,finally less the IUA incidence.Study reported about how estrogen and progesterone helped evacuation residua when go with expectant treatment,we observed 16 outpatients dealing with estrogen and progesterone to prove it’s efficient and safe.But it’s needed for those study with large sample and comparison between hormone therapy and only expectant treatment.Since the high incidence of RPOC and curettage,it’s essential to pay more attention to RPOC and the chose of treatment,do more research to guide clinical work.