2755 Clinical Manifestations and Reproductive Outcomes of Patients Undergoing Hysteroscopic Resection of Placental Site Nodules

Abstract

Study Objective To investigate the clinical manifestations and reproductive outcomes of patients undergoing hysteroscopic resection of PSNs. Design Retrospective chart review. Setting University-affiliated fertility center. Patients or Participants Patients with secondary infertility undergoing hysteroscopic polypectomy. The study cohort was compared based on final histopathology i.e., PSN (cases) vs. endometrial polyp (controls). Interventions Operative hysteroscopy. Measurements and Main Results Demographics (age, gravidity, parity, BMI) and reproductive history (preceding pregnancy type, number of prior miscarriages, duration of infertility) was compared among the PSN and endometrial polyp groups. Live birth rate after operative hysteroscopy was considered the primary outcome. Of the 2,688 hysteroscopic procedures during the study period, 2036 (75.7%) were excluded due to non-polypectomy diagnoses. Of these, 766 were excluded due to primary infertility. The 477 patients with secondary infertility were divided into PSN (n=34) and endometrial polyp (n=413) groups based on histopathology. The overall prevalence of PSNs in the study cohort was 7.6%. The median (IQR) age, gravidity, parity and BMI of women with PSNs was 38.5 (3.9) years, 2.41 (1.2), 0.9 (0.6) and 24.8 (6.7) kg/m2, respectively. The preceding pregnancy was IVF-conceived in 53% of women; the other 47% were conceived naturally. The median number of miscarriages in women with PSNs was 1.50 (1.1), with a median infertility duration of 18.1 (9.4) months. Women with PSNs were older (38.5 vs. 35.0 years; P Conclusion Among women undergoing hysteroscopic polypectomy, PSNs are more commonly observed in women who are older and with a higher number of miscarriages when compared to women with endometrial polyps. The live birth rates after operative hysteroscopy are comparable between the groups.