Retained Products of Conception (RPOC)
Definition - What does Retained Products of Conception (RPOC) mean?
Retained products of conception (RPOC) refers to persistence of placental and/or fetal tissue fragments in uterus following childbirth, planned termination of pregnancy, or a miscarriage. Symptoms often include prolonged vaginal bleeding, pelvic pain or uterine tenderness, and fever. Because all of these symptoms are non-specific, the condition is confirmed by ultrasound findings and managed with evacuation of the retained products of conception (ERPC). With an increased risk of infection and scarring, RPOC may lead to fertility issues.
FertilitySmarts explains Retained Products of Conception (RPOC)
Once diagnosed, the next step is to devise an appropriate management plan. RPOC management strategies include expectant management (wait and watch), medical management (requiring drug administration) and invasive techniques. The choice depends on factors like, mode of termination (whether it was a medical abortion or a delayed or incomplete miscarriage) and the size of gestational sac and weeks of pregnancy in a miscarriage.
For example in a delayed miscarriage, if the gestational sac is <15-20mm them expectant or medical management is preferred, if it's between 15-35mm, medication is recommended but other two can also be taken into consideration and if it's >30.35mm surgery is recommended due to high risk of bleeding and pain with the passage of products.
Dilation and curettage (D&C) is generally the treatment of choice when RPOC are confirmed; however, the procedure carries the risk of complications like uterine bleeding, infections, perforation, adhesion, and infertility.