Journal of Ultrasound in Medicine, Vol 10, Issue 7 387-395, Copyright © 1991 by American Institute of Ultrasound in Medicine
Detection of retained products of conception following spontaneous abortion in the first trimester
A. B. Kurtz, R. D. Shlansky-Goldberg, H. Y. Choi, L. Needleman, R. J. Wapner and B. B. Goldberg
Department of Diagnostic Ultrasound, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107-5244.
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.
