Retained products of gestation in miscarriage: an evaluation of transvaginal ultrasound criteria for diagnosing an "empty uterus".
OBJECTIVE
The purpose of this study was to compare clinical outcomes of conservative management versus surgical evacuation of retained products of gestation after misoprostol treatment for first trimester spontaneous miscarriage using less restrictive transvaginal ultrasound criteria for diagnosing "empty uterus," which were managed conservatively.


METHODS
This was a prospective, randomized, controlled trial.


RESULTS
Forty-six patients who had sonographic features previously regarded as significant retained products of gestation after misoprostol treatment, ie, homogenous intrauterine dimension of more than 11 cm 2 in combined transverse and sagittal plane, or those with heterogeneous intrauterine contents were consented to randomization. The short-term complication rates of those managed conservatively were significantly higher than surgical evacuation ([9/24] 37.5% vs [0/21] 0%, P < .05).


CONCLUSIONS
Our previously reported transvaginal ultrasound criteria of homogenous intrauterine dimension of less than 11 cm 2 in combined transverse and sagittal planes for defining "empty uterus," which requires no further treatment, cannot be "relaxed" without incurring additional complications.
Leung
S W
SW
Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR. swleung@alumni.cuhk.edu.hk
Pang
M W
MW
Chung
T K H
TK
D000020:Abortifacient Agents, Nonsteroidal; D000022:Abortion, Spontaneous / Q000150:complications*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D016595:Misoprostol; D018457:Placenta, Retained / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011446:Prospective Studies; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol