Effects of postpartum uterine curettage in the recovery from Preeclampsia/Eclampsia. A randomized, controlled trial

Abstract

Objective: To evaluate if postpartum uterine curettage improved the clinical and laboratory parameters in patients with preeclampsia or eclampsia.

Methods: A total of 442 patients with preeclampsia/eclampsia were randomized to postpartum curettage (223) or no procedure (219). Systolic and diastolic blood pressure were recorded and analyzed at hours 6, 12, 24 and 48. Also, several laboratory values and diuresis were evaluated.

Results: No statistical differences were found between groups (curettage vs. no procedure) in regards to systolic [155.74(15.43) vs. 156.81(15.58)] and/or diastolic blood pressure [101.51(11.44) vs. 101.70(11.20)] before and after the allocated procedure, starting at hour 6 [SBP: 134.19(13.11) vs. 136.65(15.36); DBP: 87.20(9.42) vs. 88.57(10.98)] and up to 48 h after delivery [SBP: 126.59(15.54) vs. 128.21(13.85); DBP: 81.86(9.92) vs. 81.67(11.33)]. No statistical differences between groups were found in the rate of recovery of laboratory values, as well as in the need for additional antihypertensive medications in the postpartum period. These results applied to patients with severe preeclampsia (210 patients in both arms) and eclampsia (13 vs. 9). There were no cases of postpartum eclampsia or acute renal failure after delivery in any of the groups.

Conclusion: To perform a postpartum uterine curettage does not present an advantage in the patient with preeclampsia/eclampsia. The procedure dos not improve clinical or laboratory values.

Keywords: Eclampsia; Postpartum uterine curettage; Preeclampsia.