Application of narrow-band imaging combined with hysteroscopic 7Fr cold knife in the treatment of missed early miscarriage.

Abstract

Purpose: The application of narrow-band imaging for missed early miscarriage treatment remains unclear. This study determined the application advantages of NBI combined with hysteroscopic 7Fr cold knife embryo removal for treating missed early miscarriage.

Methods: A retrospective selection of 208 patients who were hospitalized for missed early miscarriage at Hubei Provincial Maternal and Child Health Hospital from January 2023 to June 2023 were included. The patients were divided into three groups according to the treatment methods: Group A (medical abortion), Group B (NBI combined with hysteroscopic 7Fr cold knife), and Group C (ultrasound-guided vacuum aspiration). The clinical data of the three groups were analyzed, and endometrial recovery after treatment was compared to identify risk factors affecting complications after treatment for missed early miscarriage.

Results: The endometrial thickness was greatest in Group A and thinnest in Group C two weeks post-treatment. Group B had the earliest menstrual recovery and the lowest intrauterine residual and intrauterine adhesion incidences. The pregnancy termination method was the only independent risk factor for intrauterine adhesions after treatment. The time to menstrual recovery after treatment, the serum beta-human chorionic gonadotropin level at 2 weeks post-treatment, and the endometrial thickness had predictive value for intrauterine retention. The combined prediction of the above indicators showed high accuracy.

Conclusion: The use of NBI combined with hysteroscopic 7Fr cold knife embryo removal in patients with missed early miscarriage results in a lower risk of intrauterine residuals and IUA than ultrasound-guided vacuum aspiration and medical abortion. This approach leads to earlier menstrual recovery and protects the endometrium.