Design: Retrospective chart review.

Setting: Urban academic health system.

Patients or Participants: All patients undergoing repeat dilation & curettage (D&C) or hysteroscopy (HSC) within 12 weeks of initial surgical procedure for retained products of conception (rPOC).

Interventions: The Enterprise Data Warehouse was queried. Indication for procedure was identified by preoperative ICD-10 code. Procedures were identified by postoperative CPT codes.

Measurements and Main Results: From January 2018 – December 2023, 57 patients were identified that underwent repeat D&C or HSC within twelve weeks after an initial (index) procedure. Of the procedures requiring reintervention, the index procedure was more often D&C (56%, 32/57) rather than HSC (43.9%, 25/57). Of the procedures requiring reintervention, the most common index procedure code was rPOC, after miscarriage (50.9%, 29/57), followed by rPOC in the postpartum period (42.1%, 24/57), with minority of procedures performed for rPOC after dilation & evacuation (7.0%, 4/57). Index pathology was most often identified as villi (68%, 38/57), as was pathology after first repeat procedure (43.6%, 24/57). If HSC was performed as index procedure, the repeat procedure was significantly more likely to be HSC (84%, 21/25) than D&C (16%, 4/25). For rPOC in the postpartum period, D&C was the most common index procedure (66.7%, 16/24); whereas for rPOC after miscarriage, HSC (48.3%, 14/29) and D&C were equally common index procedures (51.7%, 15/29).

Conclusion: Of procedures requiring reintervention for retained products of conception, the index procedure was more often D&C rather than HSC. This finding suggests that HSC may lower the risk of surgical reintervention for retained products of conception.