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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:1053-1060 • 0278-4297

Postabortion Doppler Evaluation of the Uterus

Incidence and Causes of Myometrial Hypervascularity

Ercüment Müngen, MD, Özgür Dundar, MD and Ali Babacan, MD

Department of Obstetrics and Gynecology, Gülhane Military Medical Academy Haydarpasa Training Hospital, Üsküdar, Istanbul, Turkey.

Address correspondence to Ercüment Müngen, MD, Gülhane Military Medical Academy Haydarpasa Egitim Hastanesi, Kadin Hastaliklari ve Dogum Klinigi, Üsküdar, 34668 Istanbul, Turkey., E-mail: emungen{at}gmail.com

Objective. The aim of this study was to investigate the incidence and causes of uterine hypervascular lesions showing low-impedance, high-velocity flow on color Doppler sonography (CDS) after first-trimester dilation and curettage (D&C). Methods. This was a prospective study of 65 consecutive women who underwent first-trimester termination of pregnancy. Color Doppler sonography of the uterus was performed on days 3 and 10 after D&C. If the myometrial hypervascularity (MH) persisted on day 10, a second D&C was performed, and then the patients were followed with weekly Doppler examinations. Results. In 16 of 65 women (24.6%), MH was detected with CDS on day 3 after D&C. In 3 cases, MH resolved spontaneously by postabortion day 10. In the remaining 13 patients, the second D&C performed on day 10 revealed retained products of conception (RPOC) in 8 patients (61.5%), a hydatidiform mole in 2 (15.4%), endometritis in 1 (7.7%), and no abnormality in 2 (15.4%). Complete resolution of the MH occurred in all cases. The mean period to the resolution of MH after the second D&C ± SD was 16.54 ± 11.06 days (range, 7–48 days). Univariate analysis revealed that gestational age at D&C (P = .012) and a history of any uterine surgery (P = .044) were significantly associated with postabortion MH. On binary logistic regression analysis, gestational age at D&C was the only independent predictive factor for MH (P = .016; odds ratio, 1.47; 95% confidence interval, 1.08–2.02). Conclusions. The presence of hypervascular areas within the myometrium is a common finding in the postabortion period, and in most cases, the cause of this finding is RPOC.

Key Words: abortion • color Doppler sonography • myometrial hypervascularity • uterus

Abbreviations: AVM, arteriovenous malformation • CDS, color Doppler sonography • D&C, dilation and curettage • EMV, enhanced myometrial vascularity • RPOC, retained products of conception

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