Detection of retained products of conception following spontaneous abortion in the first trimester.
A retrospective analysis was performed to determine whether ultrasound could reliably rule in or out retained products of conception (POC) in women after first-trimester spontaneous abortions (miscarriages). Ninety-seven first-trimester pregnancies with pathologically proven results from dilatation and curettage (D&C) were studied within 7 days of ultrasound examination (60% within 2 days), either by the abdominal or a combination of abdominal and vaginal approaches. Cases were eliminated if there was clinical evidence of a spontaneous evacuation of POC during the interval between the ultrasound and the D&C. POC were diagnosed only if chorionic villi were evident pathologically. The pertinent ultrasound findings were related to the endometrium (thickness, echogenicity, a gestational saclike structure or a space-occupying collection). The results indicated that ultrasound could correctly diagnose POC in all of the cases by detecting a gestational sac or collection (77 cases), or a thickened endometrium of greater than 5 mm (6 cases). Ultrasound was less reliable in ruling out retained POC. When only a thin endometrial stripe of less than 2 mm was present, there was little likelihood of having POC (1 of 7 cases) with a moderately thick endometrium of 2 to 5 mm not diagnostic. Vaginal ultrasound added little new information and failed to change the ultrasound interpretation.
Kurtz
A B
AB
Department of Diagnostic Ultrasound, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107-5244.
Shlansky-Goldberg
R D
RD
Choi
H Y
HY
Needleman
L
L
Wapner
R J
RJ
Goldberg
B B
BB
D000027:Abortion, Incomplete / Q000000981:diagnostic imaging* / Q000473:pathology; D000022:Abortion, Spontaneous / Q000000981:diagnostic imaging / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000650:Amnion / Q000000981:diagnostic imaging / Q000473:pathology; D002823:Chorion / Q000000981:diagnostic imaging / Q000473:pathology; D003656:Decidua / Q000000981:diagnostic imaging / Q000473:pathology; D004107:Dilatation and Curettage; D004717:Endometrium / Q000000981:diagnostic imaging; D005260:Female; D005865:Gestational Age; D006801:Humans; D009215:Myometrium / Q000000981:diagnostic imaging; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology; D015017:Yolk Sac / Q000000981:diagnostic imaging / Q000473:pathology