Ophélie Revret, Louis Van Hees, Charlotte Maillard, Mathieu Luyckx, Amandine Gerday
This mini-series suggests that HsR is a feasible technique for first trimester VIP, ideally applicable to pregnancies of up to nine of amenorrhoea. Fertility gains are expected from the minimal endometrial damage permitted by the technique. The findings are limited by the small sample size, making it difficult to draw definitive conclusions regarding the safety or efficacy of hysteroscopy compared with medical management or D&C. Although hysteroscopy appears to be a safe and promising approach, larger prospective studies are needed to confirm these findings and better compare outcomes with those of D&C.
OBJECTIVE: Although surgical techniques for later interruption have advanced since the legalisation of voluntary interruption of pregnancy (VIP), dilatation and curettage via aspiration (D&C) remains the conventional approach. Hysteroresectoscopy (HsR) presents a potential alternative. This study aims to evaluate the feasibility of using HsR to perform VIP in cases in the early first trimester.
DESIGN: A case series involving patients treated for VIP in our department.
PATIENTS: Women seeking VIP between six and ten weeks of amenorrhoea.
INTERVENTION: Hysteroscopic resection following cervical dilatation, performed as an outpatient procedure under general or spinal anaesthesia.
RESULTS: Between January 2021 and January 2026, 15 patients underwent VIP via HsR at our institution. One suspected case of uterine perforation was reported, and one patient experienced retained products of conception, which were managed with hysteroscopy performed in consultation without anesthesia. Additionally, 46,6% of patients received simultaneous contraception implantation.
CONCLUSION: This mini-series suggests that HsR is a feasible technique for first trimester VIP, ideally applicable to pregnancies of up to nine of amenorrhoea. Fertility gains are expected from the minimal endometrial damage permitted by the technique. The findings are limited by the small sample size, making it difficult to draw definitive conclusions regarding the safety or efficacy of hysteroscopy compared with medical management or D&C. Although hysteroscopy appears to be a safe and promising approach, larger prospective studies are needed to confirm these findings and better compare outcomes with those of D&C.