The Correlation Between Clinical Diagnosis of Retained Placenta And Histology
Condition: Retained Product of Pregnancy
MeSH terms: Placenta, Retained
Study type: Observational

Summary: 
      The main purpose is to evaluate the correlation in qualitative and quantitative manner
      between clinical diagnosis of retained placenta and histology. Secondly, to assess different
      clinical parameters that are likely related to accuracy of the diagnosis of RPOC
    

Detailed description: 
      Background:

      Retained products of conception (RPOC) are a common and treatable complication after delivery
      or termination of pregnancy. The reported incidence in the literature is around 1% of all
      pregnancies. Most often, diagnoses are made on clinical basis and there is only scarce
      information available related to the correlation between the clinical and pathological
      diagnosis of RPOC. The gold standard for diagnosis of RPOC is based on histopathological
      confirmation of chorionic villi in tissue derived from the uterus. Once RPOC is diagnosed on
      a clinical basis, several treatment options are available, including expectant management,
      pharmacological treatment, and surgical interventions. Given the risks associated with
      surgical interventions, accurate diagnosis is vital. Guidelines at Maccabi Health Care
      Organization mandate that hysteroscopic removal of suspected RPOC should be performed only
      after approval by a Gynecological Surgical Preauthorization committee. Based on the activity
      of this committee and starting 2011, Maccabi has developed a database on certain
      gynecologic-surgical procedures including hysteroscopic removal of suspected RPOC.

      Purpose of the study:

      The main purpose is to evaluate the correlation in qualitative and quantitative manner
      between clinical diagnosis of retained placenta and histology.

      Expected results:

      70% correlation between the clinical and pathological diagnosis of RPOC.

      Methods:

      Establishing a dedicated database which includes demographic, clinical and histological data
      of women who have undergone hysteroscopic removal of suspected RPOC and statistical
      assessment of correlations.

      Significance:

      Determination of the correlation between clinical suspicion and histological diagnosis of
      retained placental tissue Finding clinical parameters that may increase the accuracy of this
      diagnosis and will help to prevent unnecessary procedures.
    

Intervention name(s): no interventions
Intervention type(s): Other
Intervention description(s): no interventions
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Study population consists of women who were diagnosed clinically with the rest of the
        placenta after birth or termination of pregnancy (miscarriage or artificial). The women
        passed the approval of the Commission and undergo therapeutic hysteroscopy. The information
        is taken from a database of relevant actions Maccabi Healthcare Services, and includes data
        from 2012 to 2015.
      
Keywords: Retained placenta, surgical hysteroscopy, residua