RPOC stands for retained products of conception. It is a medical condition wherein tissues from the placenta, fetus, or embryo remain inside the uterus after a pregnancy ends. This causes symptoms like fever, missed periods, pelvic pain, and heavy bleeding.

Ask your doctor to check for these leftovers when a pregnancy ends or you experience such symptoms. Timely intervention can help avoid heavy bleeding, infection, and other complications. When the bleeding is significant, it can be hypervascular RPOC, indicating a high level of vascularity within the retained tissue.

Nowadays, we use an advanced, non-surgical, and safe procedure called uterine artery embolisation (UAE). It has shown impressive results in reducing vascularity, stopping bleeding, preserving the uterus, and removing unwanted tissues from the uterus.

What is hypervascular RPOC?

Hypervascular RPOC refers to the condition where tissue remaining in the uterus after a pregnancy ends has increased blood flow. This leads to heavy bleeding and other complications, including impact on future pregnancies.

RPOC can occur after a vaginal delivery, C-section, abortion, and miscarriage. It complicates 1% to 5% of all pregnancies. Thus, it is important to get it diagnosed early for prompt treatment.

Causes:

While there is no exact known cause, experts believe some factors play a major role. These include:

  • History of RPOC
  • Pregnancy at the age of 35 years or above
  • Delivery using instruments like vacuum or forceps
  • Abortion
  • Miscarriage
  • Abnormal uterus shape
  • Placenta accreta (Placenta grows too deeply into the uterine wall)
  • Failure to progress (Labour doesn’t progress normally)
  • Scarring in the uterus due to past surgery

Symptoms:

Some bleeding or vaginal discharge is normal after a pregnancy ends. However, heavy bleeding or blood clots could be an indication of an underlying condition like RPOC.

Following are some of the common signs of RPOCs:

  • Heavy or irregular vaginal bleeding
  • Missed menstrual bleeding
  • Fever
  • Pelvic pain
  • Infection

Complications:

If the retained products of conception are not removed timely, they can lead to complications, sometimes serious and long-lasting:

  • Anaemia due to significant bleeding
  • Chronic pelvic pain
  • Infection in the reproductive system
  • Asherman’s syndrome (Scar tissue buildup inside the uterus)

Diagnosis:

As discussed earlier, some bleeding and vaginal discharge after a pregnancy ends is normal. But if it is significant or you are having the above-mentioned symptoms, you should talk to a healthcare expert.

The doctor will examine your symptoms and if he suspects any problem, you may be recommended a few tests like:

B-HCG test: This blood test measures the level of human chorionic gonadotropin (HCG) in the body. Having a high HCG level could be an indication of RPOC.
Ultrasound & Colour Doppler: These tests
Colour Doppler ultrasound: This test helps the doctor find blood supply to any extra tissue inside the uterus.
Contrast-enhanced MRI: This imaging technique uses a contrast agent to check for any changes in the uterus,

Treatment:

The treatment options for RPOC include medical treatment, surgical intervention, and non-invasive procedures like uterine artery embolisation (UAE). The former two options have been used for years but have not shown promising results or are too aggressive and can cause complications.

On the other hand, uterine artery embolisation being an advanced, minimally invasive, and safe procedure has shown impressive clinical results and prevented numerous hysterectomies (surgical removal of the uterus).

The procedure takes around 20 to 30 minutes and is performed under conscious sedation. During the procedure, the doctor inserts a flexible, thin catheter into the uterine arteries through the groin or hand.

The doctor uses imaging guidance to move the catheter to the right position. Once it reaches the targeted area, it releases small particles (embolic particles) to block the blood flow to the affected area. This causes the extra tissues to shrink and stop bleeding. Sometimes doctors may suggest a D&C procedure after a UAE for the removal of the extra tissue from the uterus.

Uterine artery embolisation helps stop heavy bleeding and prevent uterus removal, making it one of the best treatment options for RPOC. It gives you the chance to retain your uterus, which is an integral part of your body and plays an important role in physical, mental, hormonal, and sexual well-being.

Aakash Healthcare is one of the best hospitals in Delhi, India, for uterine artery embolisation treatment. Our team of experts have been using this treatment option for a range of uterus problems, including hypervascular RPOC. UAE has shown excellent outcomes, with patients reporting relief in their symptoms.

with Dr. Abhishek Bansal

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