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Hum. Reprod. Advance Access published online on October 13, 2006
Human Reproduction, doi:10.1093/humrep/del299
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received April 11, 2006
Revised June 26, 2006
Accepted June 30, 2006

Article

The occurrence and outcome of 39 pregnancies after 1621 cases of transcervical resection of endometrium

Enlan Xia 1 *, Tin-Chiu Li 2, Dan Yu 3, Xiaowu Huang 1, Jie Zheng 1, Yuhuan Liu 1, and Mei Zhang 1

1 Hysteroscopic Center, Fuxing Hospital Affiliate of Capital University of Medical Sciences, Beijing, China
2 The Jessop Wing, Royal Hallamshire Hospital, Sheffield, UK
3 Hysteroscopic Center, Fuxing Hospital Affiliate of Capital University of Medical Sciences, Beijing, China; The Jessop Wing, Royal Hallamshire Hospital, Sheffield, UK

* To whom correspondence should be addressed.
Enlan Xia, E-mail: xiaenlan{at}public.bta.net.cn


  Abstract

BACKGROUND: To evaluate the outcomes and management of pregnancy after transcervical resection of the endometrium (TCRE). METHODS: Retrospective study of 39 pregnancies after 1621 procedures of TCRE. RESULTS: Among 1621 women who were successfully followed up after TCRE, there were 39 pregnancies in 32 women, including five ectopic pregnancies (12.8%) and 34 intrauterine pregnancies (87.2%). The majority of pregnancies (84.6%) occurred within the first 2 years. In the first year after TCRE, the incidence of pregnancy was 1.5%. In women who had amenorrhoea after TCRE, the chances of conception (2/676; 0.3%) were significantly (P < 0.001) lower than for those who continued to have period (30/945; 3.2%). Thirty-two cases with intrauterine pregnancy were terminated under ultrasound guidance with two difficult procedures. Only one pregnancy in our study resulted in spontaneous miscarriage which was managed by suction curettage. One term pregnancy had placenta increta resulting in Caesarean hysterectomy. CONCLUSIONS: Pregnancies after TCRE are associated with increased risk, and clinicians should be aware of the various complications of pregnancy that may occur after TCRE, including an increased risk of ectopic pregnancy. Surgical termination of pregnancy after TCRE is potentially a difficult procedure and should be carried out under ultrasound guidance.

Keywords: complication/ectopic pregnancy/endometrial resection/pregnancy/termination.
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