July 19th, 2019

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A Comparison of Surgical Treatments of Early Pregnancy Loss Due to Undiagnosed Complete or Partial Mole: Office Manual Vacuum Aspiration Is a Safe Option
Authors:  Erika L. Mowers, M.D., Katherine Pasque, M.D., Jason Bell, M.D., M.P.H., Giselle Kolenic, M.A., and Vanessa K. Dalton, M.D., M.P.H.
  OBJECTIVE: To compare complication rates for women with early pregnancy loss due to molar pregnancy who underwent uterine aspiration in the office versus the operating room.

STUDY DESIGN: We identified women with histopathology-proven molar pregnancy after undergoing a uterine evacuation procedure for early pregnancy loss between January 1, 2001, and December 31, 2011. We conducted a retrospective chart review to compare complication rates of manual vacuum aspiration in the office versus electric vacuum aspiration in the operating room.

RESULTS: We identified 123 women with histopathology-confirmed molar pregnancy. Forty-six patients underwent office manual vacuum aspiration instead of electric vacuum aspiration in the operating room. Patients who underwent office manual vacuum aspiration were less likely to have blood loss >300 cc (4.3% vs. 42.9% in the operating room group, p<0.001). There were no other significant differences in complication rates. Multivariable logistic regression models demonstrate that the risk of hemorrhage (estimated blood loss >300 cc) was significantly lower for office procedures than for operating room procedures (OR 0.26, 95% CI 0.09–0.72) when controlling for β-hCG values and gestational age.

CONCLUSION: Office manual vacuum aspiration is a safe treatment option for patients experiencing early pregnancy loss, including women with an undiagnosed molar pregnancy.
Keywords:  dilatation and curettage, early pregnancy loss, hydatidiform mole, manual vacuum aspiration, molar pregnancy, spontaneous abortion, vacuum curettage
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