Journal of Ultrasound in Medicine, Vol 16, Issue 4 257-261, Copyright © 1997 by American Institute of Ultrasound in Medicine
Transvaginal sonohysterography for the early diagnosis of residual trophoblastic tissue
I. Wolman, J. Hartoov, D. Pauzner, A. Grutz, A. Amit, M. P. David and A. J. Jaffa
Ultrasound Unit in Obstetrics and Gynecology, Serlin Maternity Hospital, Tel Aviv Medical Center, Israel.
We prospectively evaluated 29 patients with early postabortion or
postpartum bleeding, suspected of having possible retained trophoblastic
tissue by transvaginal sonography and transvaginal sonohysterography. All
patients received methyl-ergometrine maleate (Sandoz) and amoxicillin and
clavulinic acid (Pharmascope) orally for 5 days and were then reevaluated.
Ten patients (34.5%) had a normal uterine cavity on both transvaginal
sonography and sonohysterography. Nineteen patients (65.5%) were suspected
of having residual trophoblastic tissue by transvaginal sonography. Of
these, five (26%) showed normal uterine cavity by sonohysterography. One
patient (8.3%) reported heavy bleeding with clots after the conservative
treatment. Repeated examination revealed normal uterine cavity. The
remaining patients underwent curettage, and histopathologic examination
revealed trophoblastic tissue. Transvaginal sonohysterography is more
accurate than transvaginal sonography for diagnosing residual trophoblastic
tissue in patients with postpartum and postabortion bleeding. Its use may
eliminate unnecessary curettage procedures.
