Detection of retained products of conception : colour doppler study

Abstract EN

Objective : to assess the diagnostic value of colour Doppler examination of endometrial blood vessels for detection of retained products of conception.

Patients & methods : 60 women who were clinically diagnosed as having incomplete first trimester spontaneous abortion at AL-Zahraa University Hospital.

Inclusion criteria were : positive pregnancy test, gestational age less than 14 weeks, products of conception have partially passed from the uterine cavity, protruding from the external os, or in the vagina with persistent bleeding and cramping or history of heavy vaginal bleeding.

TVCD of cases of incomplete abortion which classified according to vascularity in 4 groups : type 0 : no vascularity, Type 1 : low vascularity, Type 2 : moderate vascularity, Type 3 : high vascularity.

The presence of a colour Doppler signal and the amount of endometrial vascularity were assessed as none, minimal, moderate, or marked.

Quantification of blood flow was done using, resistance index (RI).

Results : 42 of study group were diagnosed by histopathological examination as RPOC and the other 18 patients were diagnosed as Non RPOC.

Demographic data of study group was : 53.3 % were para 0, 38.3 % were para two and 55 % had history of 2 abortion.

As regard presenting symptoms of the patients, most of them was complaining of vaginal bleeding (75 %), also 60 % were complaining of abdominal cramps.

The comments type of vascularity was type 0 (no vascularity) (31.6 %) then type 2 (moderate vascularity) (30 %).

85.7 % (36 / 42) of cases of RPOC confirmed by histopathology, showed presence of vascularity in Doppler U / S.

All cases of type 2&3 vascularity showed RPOC by histopathological examination.

There is no significant difference in RI and in RPOC & Non RPOC.

Conclusion : TVCD as a sensitive, specific and noninvasive method have a significant place in the diagnostic procedures for evaluation of retained products of conception.