Role of Sonography in the Diagnosis of Retained Products of Conception

Journal of Ultrasound in Medicine - Tập 23 Số 3 - Trang 371-374 - 2004
Oscar Sadan1,2, Abraham Golan1,2, Ofer Girtler1,2, Samuel Lurie1,2, Abraham Debby1,2, Ron Sagiv1,2, Shmuel Evron1,2, Marek Glezerman1,2
1Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
2Sackler faculty of medicine, Tel-Aviv, Israel

Tóm tắt

Objective. To present our experience with clinical and sonographic diagnosis of retained products of conception and to evaluate its correlation with histopathologic findings. Methods. This was a retrospective study on 156 patients admitted for retained products of conception. Women were referred because of 1 or more of the following: abdominal pain, bleeding, and fever. The status of the cervix was evaluated by bimanual examination. The diagnosis of retained products of conception was made when a sonographic finding of hyperechoic or hypoechoic material was seen in any part of the uterine cavity or the presence of a thickened endometrial stripe greater than 8 mm and an irregular interface between the endometrium and myometrium was found. One hundred twenty‐one women (77.6%) were admitted after dilation and curettage for abortion, and 35 (22.4%) were admitted after spontaneous labor. Results. Histopathologic reports confirmed the diagnosis of retained products of conception in 86 (71%) of 121 women in the postabortion group and in 17 (48.5%) of 35 women in the postpartum group. The overall false‐positive rate for sonographic diagnosis was 34%. For women after abortion and after delivery, the false‐positive rates were 28.9% and 51.5%, respectively. Conclusions. Reliance on common signs and symptoms to diagnose retained products of conception as well as the use of sonography is associated with an unacceptably high false‐positive rate, mainly after delivery. A more conservative approach to the treatment of retained products of conception is suggested.

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Tài liệu tham khảo

1894, Gynaekol, 18, 1337

10.1111/j.1471-0528.1948.tb07045.x

10.1002/jcu.10086

1993, NZ Med J, 106, 83

1981, Ann Chir Gynaecol, 70, 331

10.7863/jum.1991.10.7.387

10.7863/jum.1991.10.8.451

10.1046/j.1469-0705.1995.06020126.x

1993, Obstet Gynecol, 81, 507

10.7863/jum.1997.16.4.257

10.1159/000291838

10.7863/jum.2001.20.12.1277

10.1016/S0015-0282(16)43568-5