Transvaginal color Doppler ultrasonography in the management of first-trimester spontaneous abortion.
OBJECTIVE
To evaluate the role of transvaginal color Doppler ultrasonography in the management of first-trimester spontaneous abortion, clinically thought to be complete.


METHODS
A prospective interventional non-randomized study was performed in a tertiary care University hospital. Sixty-two women with suspected first-trimester spontaneous abortion, clinically thought to be complete were included in the study. All women were evaluated on admission by transvaginal color Doppler ultrasonography. The amount of blood flow within the myometrium or in the endometrium-myometrium interface was assessed. Those women with suspected retained tissue on color Doppler were scheduled to undergo dilatation and curettage (D&C). Those patients with no suspected retained tissue on color Doppler were scheduled for expectant management.


RESULTS
Eighteen women had suspected retained tissue and 44 women did not. A total of 16 out of 18 (88.9%) patients had retained trophoblastic tissue confirmed on histopathologic analysis. There were two false negative cases. Outcome of all patients managed expectantly was optimal with no complications.


CONCLUSIONS
Transvaginal color Doppler ultrasonography is useful to detect or to rule out the presence of retained trophoblastic tissue after first-trimester spontaneous abortion and to select patients for expectant management.
Alcázar
Juan Luis
JL
Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain. jlalcazar@unav.es
Ortiz
Claudia A
CA
D000022:Abortion, Spontaneous / Q000000981:diagnostic imaging*; D000328:Adult; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D018457:Placenta, Retained / Q000000981:diagnostic imaging / Q000601:surgery; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color