Journal of Ultrasound in Medicine, Vol 20, Issue 8 877-881, Copyright © 2001 by American Institute of Ultrasound in Medicine
Sonohysterography for the diagnosis of residual trophoblastic tissue
Y. Zalel, S. B. Cohen, M. Oren, D. S. Seidman, M. Zolti, R. Achiron and M. Goldenberg
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
OBJECTIVE: To assess the efficacy, safety, and associated complications of
sonohysterography for the diagnosis of residual trophoblastic tissue.
METHODS: We conducted a prospective study of 23 consecutive patients
admitted to our ultrasonography unit with clinical and ultrasonographic
signs of retained intrauterine tissue. RESULTS: Twelve patients had
hydrosonographic features suggestive of residual trophoblastic tissue
(i.e., an intrauterine lesion not detachable from the uterine wall after
instillation of saline), whereas in 11 cases the hydrosonographic findings
were negative for retained tissue. Blood flow was detected within abnormal
intrauterine masses in 4 of 12 patients with trophoblastic tissue, whereas
it was not detected in any patient without retained tissue (P = .093). No
complications were encountered during the procedure or the postprocedure
period. None of the patients had anesthetic complications, perforation of
the uterus, fluid overload, or any other surgical complication. All 12
patients underwent hysteroscopic removal of the suspected residual
trophoblastic tissue, and histologic confirmation of residual trophoblastic
tissue was obtained in all cases. CONCLUSIONS: Sonohysterography for
detection and diagnosis of residual trophoblastic tissue is an accurate and
safe procedure. Further studies comparing the efficacy of sonohysterography
with that of diagnostic hysteroscopy are warranted.