A "See and treat" office procedure for retained products of conception removal after normal vaginal delivery using manual vacuum aspiration: Preliminary efficacy and reproductive outcomes.

To compare efficacy and reproductive outcomes of an ultrasound guided manual vacuum aspiration (MVA) procedure to the widely accepted operative hysteroscopy (OH) procedure in removal of retained products of conception (RPOC) after normal vaginal delivery.Retrospective cohort study (Canadian Task Force classification II-2) SETTING: University-affiliated tertiary medical center PATIENTS: Eighty-six patients after normal vaginal delivery diagnosed with RPOC from 2005 through 2015. This study was approved by the local institutional review board INTERVENTIONS: treatment with either MVA or OH for patients diagnosed with RPOC MEASUREMENTS AND MAIN RESULTS: Of 86 patients, 23 underwent remnant removal by ultrasound guided MVA using a 6-7 mm catheter in a "See and treat" office procedure. Sixty-three patients underwent remnant removal in an operative hysteroscopy. Follow up included sonographic examination 3-5 weeks after the procedure and long term follow up on complications and reproductive outcomes. Successful remnant evacuation and overall complications rates were similar when comparing the MVA group and the OH group (95.7% vs. 96.8% and 4.3% vs. 4.7%, respectively).Conception rates as well as miscarriage rates were again comparable in the MVA and OH groups (78.6% vs. 72.2% and 9.1% vs. 14.8%,respectively).Preliminary results from 23 patients suggest that MVA is an efficient procedure with low complication rates and satisfactory reproductive outcomes. It does not require anesthesia or operating room facilities therefore allowing an immediate and inexpensive "See and treat" option for retained products of conception removal. Further larger controlled trials are required.