Hysteroscopy vs. Endouterine Aspiration in the Management of Trophoblastic Retention (HARET)
Miscarriage
About this trial
This is an interventional treatment trial for Miscarriage focused on measuring Miscarriage, Hysteroscopy, Aspiration, Fertility, Synechiae
Eligibility Criteria
Inclusion Criteria: Management for trophoblastic retention after early spontaneous miscarriage (<14 weeks of amenorrhea) Diagnosis of intrauterine trophoblastic retention by endovaginal pelvic ultrasound Shared decision for surgical management Current pregnancy desire Exclusion Criteria: Known uterine malformation Patient who has received surgical treatment for current intrauterine retention Trophoblastic retention after elective termination, late miscarriage and postpartum Patient with an intrauterine device (IUD) Pregnancy obtained by medically assisted procreation Indication for emergency surgical management for haemostatic purposes Failure to obtain free, informed and written consent after a period of reflection Person not affiliated or beneficiary of a national health insurance system Person protected by law, under guardianship or curatorship Person participating in other interventional research involving the human person
Sites / Locations
- CHU de Bordeaux - Hôpital PellegrinRecruiting
- CHU de Montpellier - Hôpital Arnaud de VilleneuveRecruiting
- CHU de Nice - Hôpital Archet II
- CHU de Nîmes - Hôpital CarémeauRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Arm A: Hysteroscopy
Arm B: Aspiration
Patients randomized to the hysteroscopy arm will receive misoprostol antibiotic prophylaxis to dilate the cervix before surgery, and anti-adhesion barrier gels will be used, according to routine procedures at each center. In case of intrauterine retention complicated by endometritis, antibiotic treatment for 48 hours (penicillin, metronidazole, fluoroquinolones or a combination of these antibiotics) will be administered according to the standard practice of each center. Evacuated retention product will be sent for pathological examination. Rh-negative women will receive prophylaxis to prevent Rh alloimmunization.
Patients randomized to the aspiration arm will receive misoprostol antibiotic prophylaxis to dilate the cervix before surgery and anti-adhesion barrier gels will be used, according to routine procedures at each center. In case of intrauterine retention complicated by endometritis, antibiotic treatment for 48 hours (penicillin, metronidazole, fluoroquinolones or a combination of these antibiotics) will be administered according to the standard practice of each center. Evacuated retention product will be sent for pathological examination. Rh-negative women will receive prophylaxis to prevent Rh alloimmunization.