The surgery to remove retained placental tissue is commonly referred to as dilatation and curettage (D&C), although hysteroscopic removal is also used.
Surgical Options for Removing Placenta
When placental tissue remains in the uterus after childbirth or a miscarriage, surgical intervention might be required. The most common procedures are:
- Dilatation and Curettage (D&C): This traditional method involves dilating the cervix and then using a curette (a surgical instrument) to scrape the uterine lining, removing any retained placental tissue. As mentioned in the provided reference, this is often performed "blindly," meaning the surgeon cannot directly see the tissue being removed.
- Hysteroscopic Removal: A more advanced technique involves using a hysteroscope, a thin, lighted tube with a camera, which is inserted through the cervix to visualize the inside of the uterus. With this method, the surgeon can use specialized instruments, like a diathermy loop, to precisely remove the retained placenta. According to the reference, this approach improves removal rates and minimizes the risk of uterine perforation.
Comparison of Methods
| Procedure | Description | Advantages | Disadvantages |
|---|---|---|---|
| Blind Dilatation and Curettage (D&C) | Cervix is dilated and a curette is used to scrape the uterine lining, removing placental tissue without direct visualization. | Relatively simple and quick. | Higher risk of incomplete removal, uterine perforation. |
| Hysteroscopic Removal | A hysteroscope provides a direct view of the uterus while specialized instruments are used to remove placental tissue. | Higher success rate of complete removal, reduced risk of uterine perforation, direct visualization. | More complex, may require specialized equipment and training. |
Conclusion
While dilatation and curettage (D&C) remains a common approach for removing placental tissue, hysteroscopic removal is gaining preference due to its increased effectiveness and reduced risks.
