421 Hysteroscopic evaluation of the uterine cavity after conservative surgical management of placenta previa

Abstract

To assess the consequences of different conservative surgical techniques used for management of intraoperative hemorrhage due to placenta previa through hysteroscopic evaluation of the uterine cavity. A cross sectional study encompassing all women managed by conservative surgical techniques during cesarean section after intraoperative hemorrhage due to placenta previa. The The study conducted in tertiary university between January 2017 and December 2018. All women were counseled for inclusion in the study before delivery during the preoperative counseling about the consequences of placenta previa. Patients who were managed by conservative surgical techniques were followed up till hospital discharge then they were contacted by phone calls for scheduled follow-up after 3 months. Office hysteroscopy for uterine cavity evaluation was done by expert gynecologist in the proliferative phase of the menstrual cycle if menses were resumed. Forty-seven women were included in the study; 14 (29.8%) were managed by compression uterine sutures, 7 (14.9%) were managed by bilateral uterine ligation only and 26 (55.3%) were managed by both of them. Regarding menses resumption, 22 (46.8%) still had amenorrhea, 13 (27.7%) had regular menses, and 12 (25.5%) had irregular menses. Hysteroscopic evaluation of the uterine cavity revealed normal cervical canal and uterine cavity with no adhesions in all cases Conservative surgical techniques for management of placenta previa had no late consequences on the uterine cavity and subsequent fertility.