Conservative management in retained product of conception: a retrospective cohort study

To evaluate the clinical course of Retained Products of Conception (RPOC) managed with expectant management or with contraceptive therapy. retrospective cohort study conducted at Policlinico di Modena (2018- 2022) including women with sonographic diagnosis of RPOC and managed conservatively with serial ultrasound (US) up to resolution. All women were offered contraceptive therapy (estroprogestin or progestin-only) but only some of them accepted. The type of management (expectant vs. medical management) was recorded and a comparison between them was made. Continuous variables were presented as mean ± standard deviation (SD), binary or categorical variables were presented as number and percentage. Continuous variables were compared using T-test student while the Chi-square test or Fisher's test were used for categorical variable. A p-value of < 0.05 was considered statistically significant. Twenty-four patients were included: 5 (20.8%) after first trimester termination of pregnancy (TOP) (2 and 3 with surgical and pharmacological TOP respectively) and 19 (79.2%) after delivery (14 after vaginal delivery and 5 after Caesarean section). 7 deliveries were complicated by early PPH. The mean interval from the first assessment to the last one was of 123.04 days (±SD 117,3). All women were offered contraceptive therapy; 66.7% (16/24) accepted. Table 1 shows the comparison between expectant vs. contraceptive treatment: no differences in terms of length of follow-up, need for readmission/ surgery or vaginal blood loss requiring A&E evaluation was found. Conservative management of RCOPs may include contraceptive therapy without additional complications compared to expectant management.