title: Choosing the optimal therapeutic strategy for placental polyps using power Doppler color scoring: Transarterial embolization followed by hysteroscopic resection or expectant management?
abstract: OBJECTIVE
  To evaluate a protocol for selection of placental polyp management, including expectant management and hysteroscopic resection with or without transarterial embolization (TAE), using power Doppler color score (PDCS) as the vascularity parameter.
  
  
  METHODS
  This retrospective case-control study included 25 patients who were diagnosed with placental polyps. We evaluated the vascularity of placental polyps with PDCS measured by transvaginal ultrasonography as follows: PDCS 1, no blood flow; PDCS 2, minimal flow; PDCS 3, moderate flow; and PDCS 4, marked blood flow. We then selected expectant management or hysteroscopic resection with or without TAE.
  
  
  RESULTS
  Three of 17 patients with PDCS 1 or 2 underwent surgical intervention, and expectant management was successful in 14. Seven of eight patients with PDCS 3 or 4 underwent surgical intervention, while expectant management was successful in only one patient.
  
  
  CONCLUSIONS
  PDCS is a simple examination for evaluating the vascularity of placental polyps. PDCS might be useful for selecting the optimal treatment for placental polyps, such as expectant management or surgical intervention, according to their vascularity.
authors: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Masahiko
authors: M
authors: Mori
authors: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: akiwase@med.nagoya-u.ac.jp.
authors: Akira
authors: A
authors: Iwase
authors: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Satoko
authors: S
authors: Osuka
authors: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Mika
authors: M
authors: Kondo
authors: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Tomoko
authors: T
authors: Nakamura
authors: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Tatsuo
authors: T
authors: Nakahara
authors: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Maki
authors: M
authors: Goto
authors: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Fumitaka
authors: F
authors: Kikkawa
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D000066491:Clinical Decision-Making / Q000379:methods*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D010920:Placenta / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D010922:Placenta Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D011127:Polyps / Q000000981:diagnostic imaging* / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods*; D057832:Watchful Waiting; D055815:Young Adult
keywords: hysteroscopic resection; placental polyps; power Doppler; transarterial embolization; vascularity