Treatment of placental polyp: Comparison of uterine artery embolization followed by transcervical resection versus observation

Abstract

  Uterine artery embolization (UAE) and transcervical resection (TCR) have been used to successfully treat placental polyps while preserving fertility. In untreated cases, reduced blood flow to the polyp has been documented during follow-up. In fact, we have seen natural recovery in some patients without treatment. In this report, we compare patients with a clinical diagnosis of placental polyp treated by observation alone versus UAE and TCR.

  Subjects included 13 patients diagnosed clinically with placental polyp at our hospital from January 2012 to December 2014. Seven patients underwent UAE and TCR and 6 patients were managed with observation. We compared age, time of onset, serum hCG level, polyp size, and blood transfusion requirement. Patients who underwent UAE and TCR showed more genital bleeding, or had been hope the next pregnancy early after abortion. One patient required blood transfusion, and fertility was preserved in all cases. Menstruation returned in five patients; one patient with a history of menstrual disorder did not show return of menstruation and one patient is currently lactating. Four patients became pregnant after the procedure.

  In patients managed with observation alone, time to confirmed cessation of blood flow on Doppler ultrasonography varied from postpartum day 25 to 201. The polyp was naturally discharged without a large amount bleeding in five patients, and one patient remains under observation. Blood flow loss period; there was no relationship between serum hCG level and polyp size at diagnosis.

  Because we were unable to estimate the duration of bleeding, it is desirable to perform observation in a facility capable of performing UAE and blood transfusion, if required. In cases where excessive bleeding occurred, treatment with UAE and TCR was effective.