Gestational sac aspiration: A novel alternative to Dilation and Evacuation for management of early pregnancy failure

Mohamed F. Mitwally, Hafsa Albuarki, Michael P. Diamond, Mostafa Abuzeid, Michael M. Fakih

Research output: Contribution to journalArticle

Abstract

Study objective: To explore the effectiveness (success, safety, and complications) of a novel technique of gestational sac aspiration in the management of early pregnancy failure as an alternative to dilation and evacuation (D&E) and conservative management. Design: Prospective historical cohort study comparing effectiveness of gestational sac aspiration (study group) to conservative management (control group) with follow-up until negative quantitative beta human chorionic gonadotropin testing is achieved (Canadian Task Force classification II-1). Setting: An infertility treatment center. Patients: Among 60 women with failed early pregnancies that were achieved by in vitro fertilization or intrauterine insemination, 20 underwent gestational sac aspiration, whereas 40 chose conservative management. Interventions: Gestational sac aspiration was done by transvaginal ultrasound-guided needle aspiration under conscious sedation. Aspirated tissue was sent for karyotyping. Both study and control (conservative management) groups received close follow-up with ultrasound and serial beta human chorionic gonadotropin measurements. Measurements and main results: There was no significant difference in age, infertility factor, or treatment between study and control groups. Mean gestational age was 8 versus 6 weeks in study and control groups, respectively (p < .05). One and 11 patients required D&E in the study and control groups, respectively (p < .05). Karyotyping was successful in all except one patient in the study group. Chromosomal abnormalities were found in 36% of products of conception. No significant complications occurred. Conclusion: Gestational sac aspiration is a simple and safe outpatient technique that is more effective than conservative management of early pregnancy failure and less invasive than D&E. Moreover, the technique provides a high probability of obtaining a noncontaminated adequate gestation tissue sample for chromosomal study.

Original languageEnglish (US)
Pages (from-to)296-301
Number of pages6
JournalJournal of Minimally Invasive Gynecology
Volume13
Issue number4
DOIs
StatePublished - Jul 1 2006
Externally publishedYes

Fingerprint

Gestational Sac
Dilatation
Pregnancy
Karyotyping
Control Groups
Chorionic Gonadotropin
Infertility
Conscious Sedation
Insemination
Age Factors
Advisory Committees
Fertilization in Vitro
Chromosome Aberrations
Gestational Age
Needles
Cohort Studies
Outpatients
Conservative Treatment
Safety
Therapeutics

Keywords

  • Dilation and evacuation
  • Early pregnancy loss
  • Gestational sac aspiration
  • In vitro fertilization
  • Miscarriage

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Gestational sac aspiration : A novel alternative to Dilation and Evacuation for management of early pregnancy failure. / Mitwally, Mohamed F.; Albuarki, Hafsa; Diamond, Michael P.; Abuzeid, Mostafa; Fakih, Michael M.

In: Journal of Minimally Invasive Gynecology, Vol. 13, No. 4, 01.07.2006, p. 296-301.

Research output: Contribution to journalArticle

Mitwally, Mohamed F. ; Albuarki, Hafsa ; Diamond, Michael P. ; Abuzeid, Mostafa ; Fakih, Michael M. / Gestational sac aspiration : A novel alternative to Dilation and Evacuation for management of early pregnancy failure. In: Journal of Minimally Invasive Gynecology. 2006 ; Vol. 13, No. 4. pp. 296-301.
@article{eed76237d4074ad59d28019ddb65b24c,
title = "Gestational sac aspiration: A novel alternative to Dilation and Evacuation for management of early pregnancy failure",
abstract = "Study objective: To explore the effectiveness (success, safety, and complications) of a novel technique of gestational sac aspiration in the management of early pregnancy failure as an alternative to dilation and evacuation (D&E) and conservative management. Design: Prospective historical cohort study comparing effectiveness of gestational sac aspiration (study group) to conservative management (control group) with follow-up until negative quantitative beta human chorionic gonadotropin testing is achieved (Canadian Task Force classification II-1). Setting: An infertility treatment center. Patients: Among 60 women with failed early pregnancies that were achieved by in vitro fertilization or intrauterine insemination, 20 underwent gestational sac aspiration, whereas 40 chose conservative management. Interventions: Gestational sac aspiration was done by transvaginal ultrasound-guided needle aspiration under conscious sedation. Aspirated tissue was sent for karyotyping. Both study and control (conservative management) groups received close follow-up with ultrasound and serial beta human chorionic gonadotropin measurements. Measurements and main results: There was no significant difference in age, infertility factor, or treatment between study and control groups. Mean gestational age was 8 versus 6 weeks in study and control groups, respectively (p < .05). One and 11 patients required D&E in the study and control groups, respectively (p < .05). Karyotyping was successful in all except one patient in the study group. Chromosomal abnormalities were found in 36{\%} of products of conception. No significant complications occurred. Conclusion: Gestational sac aspiration is a simple and safe outpatient technique that is more effective than conservative management of early pregnancy failure and less invasive than D&E. Moreover, the technique provides a high probability of obtaining a noncontaminated adequate gestation tissue sample for chromosomal study.",
keywords = "Dilation and evacuation, Early pregnancy loss, Gestational sac aspiration, In vitro fertilization, Miscarriage",
author = "Mitwally, {Mohamed F.} and Hafsa Albuarki and Diamond, {Michael P.} and Mostafa Abuzeid and Fakih, {Michael M.}",
year = "2006",
month = "7",
day = "1",
doi = "10.1016/j.jmig.2006.03.005",
language = "English (US)",
volume = "13",
pages = "296--301",
journal = "Journal of Minimally Invasive Gynecology",
issn = "1553-4650",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - Gestational sac aspiration

T2 - A novel alternative to Dilation and Evacuation for management of early pregnancy failure

AU - Mitwally, Mohamed F.

AU - Albuarki, Hafsa

AU - Diamond, Michael P.

AU - Abuzeid, Mostafa

AU - Fakih, Michael M.

PY - 2006/7/1

Y1 - 2006/7/1

N2 - Study objective: To explore the effectiveness (success, safety, and complications) of a novel technique of gestational sac aspiration in the management of early pregnancy failure as an alternative to dilation and evacuation (D&E) and conservative management. Design: Prospective historical cohort study comparing effectiveness of gestational sac aspiration (study group) to conservative management (control group) with follow-up until negative quantitative beta human chorionic gonadotropin testing is achieved (Canadian Task Force classification II-1). Setting: An infertility treatment center. Patients: Among 60 women with failed early pregnancies that were achieved by in vitro fertilization or intrauterine insemination, 20 underwent gestational sac aspiration, whereas 40 chose conservative management. Interventions: Gestational sac aspiration was done by transvaginal ultrasound-guided needle aspiration under conscious sedation. Aspirated tissue was sent for karyotyping. Both study and control (conservative management) groups received close follow-up with ultrasound and serial beta human chorionic gonadotropin measurements. Measurements and main results: There was no significant difference in age, infertility factor, or treatment between study and control groups. Mean gestational age was 8 versus 6 weeks in study and control groups, respectively (p < .05). One and 11 patients required D&E in the study and control groups, respectively (p < .05). Karyotyping was successful in all except one patient in the study group. Chromosomal abnormalities were found in 36% of products of conception. No significant complications occurred. Conclusion: Gestational sac aspiration is a simple and safe outpatient technique that is more effective than conservative management of early pregnancy failure and less invasive than D&E. Moreover, the technique provides a high probability of obtaining a noncontaminated adequate gestation tissue sample for chromosomal study.

AB - Study objective: To explore the effectiveness (success, safety, and complications) of a novel technique of gestational sac aspiration in the management of early pregnancy failure as an alternative to dilation and evacuation (D&E) and conservative management. Design: Prospective historical cohort study comparing effectiveness of gestational sac aspiration (study group) to conservative management (control group) with follow-up until negative quantitative beta human chorionic gonadotropin testing is achieved (Canadian Task Force classification II-1). Setting: An infertility treatment center. Patients: Among 60 women with failed early pregnancies that were achieved by in vitro fertilization or intrauterine insemination, 20 underwent gestational sac aspiration, whereas 40 chose conservative management. Interventions: Gestational sac aspiration was done by transvaginal ultrasound-guided needle aspiration under conscious sedation. Aspirated tissue was sent for karyotyping. Both study and control (conservative management) groups received close follow-up with ultrasound and serial beta human chorionic gonadotropin measurements. Measurements and main results: There was no significant difference in age, infertility factor, or treatment between study and control groups. Mean gestational age was 8 versus 6 weeks in study and control groups, respectively (p < .05). One and 11 patients required D&E in the study and control groups, respectively (p < .05). Karyotyping was successful in all except one patient in the study group. Chromosomal abnormalities were found in 36% of products of conception. No significant complications occurred. Conclusion: Gestational sac aspiration is a simple and safe outpatient technique that is more effective than conservative management of early pregnancy failure and less invasive than D&E. Moreover, the technique provides a high probability of obtaining a noncontaminated adequate gestation tissue sample for chromosomal study.

KW - Dilation and evacuation

KW - Early pregnancy loss

KW - Gestational sac aspiration

KW - In vitro fertilization

KW - Miscarriage

UR - http://www.scopus.com/inward/record.url?scp=33745727128&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745727128&partnerID=8YFLogxK

U2 - 10.1016/j.jmig.2006.03.005

DO - 10.1016/j.jmig.2006.03.005

M3 - Article

C2 - 16825069

AN - SCOPUS:33745727128

VL - 13

SP - 296

EP - 301

JO - Journal of Minimally Invasive Gynecology

JF - Journal of Minimally Invasive Gynecology

SN - 1553-4650

IS - 4

ER -