Intrauterine adhesions after conservative and surgical management of spontaneous abortion

Study Objective. To determine the frequency of intrauterine adhesions (IUA) after conservative management, medical evacuation, and surgical evacuation for spontaneous abortion. Design. Prospective follow-up study (Canadian Task Force classification II-2). Setting. Gynecology unit in a teaching hospital. Patients. Eighty-two women who had been treated with conservative management, medical evacuation, or surgical evacuation of retained products of conception after spontaneous abortions in a randomized, controlled trial. Measurements and Main Results. Hysteroscopic diagnosis of IUA 6 months after initial treatment was the primary outcome measure. No cases of IUA were found in patients, managed conservatively or by medical evacuation, whereas two cases (7.7%) of filmy IUA were detected in those managed by surgical evacuation. There was no statistical significant difference in the rate of self-reported reduced menstrual flow 6 months after initial treatment by any method. Conclusion. The prevalence of IUA was low after each modality of treatment fur spontaneous abortion. Conservative management and medical evacuation are both acceptable alternatives to standard surgical evacuation.