Retained products of conception

Question 1

What is retained products of conception

Answer 1

Pregnancy related tissue remains in uterus after delivery
Also occur after miscarriage or termination of pregnancy

Question 2

What is a significant risk factor for RPOC

Answer 2

Placenta accreta

Question 3

How does RPOC present

Answer 3

Vaginal bleeding - gets heavier or don’t improve with time
Abnormal vaginal discharge
Lower abdominal or pelvic pain
Fever (if infection occurs)

Question 4

Investigation for RPOC

Answer 4

US

Question 5

Management of postpartum RPOC

Answer 5

Surgical - evacuation of RPOC
Cervix widened using dilators and RPOC manually removed through rvix using vacuum aspiration and curettage (scraping)
-Dilatation and curettage

Question 6

Key complications of dilatation and curettage

Answer 6

Endometritis
Ashermans syndrome

Question 7

What is ashermans syndrome

Answer 7

Adhesions/synechiae form within uterus from scraping - damage to basal layer endometrium
If adhesions binding uterine walls together or in endocervix, seal shut -> infertility