(935) Retain Products of Conception Following Cesarean Delivery: Characteristics and Risk Factors

Untreated Retained products of conception (RPOC) may cause bleeding, infection and intrauterine adhesions which may jeopardize the woman's fertility. Literature is scarce in addressing RPOC after Cesarean delivery (CD). In this study we aimed to clarify the risk factors and prevalence of PROC after CD.

Study Design: We performed a retrospective cohort study at a single tertiary care center from 2010 to 2022. Enrolled women, delivered by CD and diagnosed with PROC confirmed by hysteroscopy. A control group of patients who had CD without RPOC was matched, in 1:4 ratio.

Results: Sixty-six women out of 14631 CDs had a hysteroscopic diagnosis of RPOC; 295 controls were matched. Table 1 provides the maternal and pregnancy characteristics. RPOC following CD was related to older age (33.42±5.38 vs. 30.59±5.08, p< 0.001), higher BMI (35.42+3.20 vs. 29.5+3.49, p=0.01), IVF conception (16.7% vs. 7.1%, p=0.01) and was less common among nulliparous patients (39.4% vs. 71.9%, p< 0.001). In addition, gestational week at delivery was earlier (37.84+2.34 vs. 40.04+1.07, p< 0.001) and most CDs were elective (62.1%). Chorioamnionits was related to higher cases of RPOC (9.1% vs. 2.4%, p=0.008), although water break duration was similar (18.44+15.83 vs. 17.83+14.16, p=0.93).

Conclusion:

Nulliparity, advanced maternal age and increased BMI are among risk factors increasing the probability of RPOC after CD delivery. This data can help gynecologists in postpartum follow-up.