Juan Luis Alcázar1, Claudia A Ortiz. 1. Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain. jlalcazar@unav.es
Abstract
OBJECTIVE: To evaluate the role of transvaginal color Doppler ultrasonography in the management of first-trimester spontaneous abortion, clinically thought to be complete. STUDY DESIGN: A prospective interventional non-randomized study was performed in a tertiary care University hospital. Sixty-two women with suspected first-trimester spontaneous abortion, clinically thought to be complete were included in the study. All women were evaluated on admission by transvaginal color Doppler ultrasonography. The amount of blood flow within the myometrium or in the endometrium-myometrium interface was assessed. Those women with suspected retained tissue on color Doppler were scheduled to undergo dilatation and curettage (D&C). Those patients with no suspected retained tissue on color Doppler were scheduled for expectant management. RESULTS: Eighteen women had suspected retained tissue and 44 women did not. A total of 16 out of 18 (88.9%) patients had retained trophoblastic tissue confirmed on histopathologic analysis. There were two false negative cases. Outcome of all patients managed expectantly was optimal with no complications. CONCLUSIONS: Transvaginal color Doppler ultrasonography is useful to detect or to rule out the presence of retained trophoblastic tissue after first-trimester spontaneous abortion and to select patients for expectant management.
OBJECTIVE: To evaluate the role of transvaginal color Doppler ultrasonography in the management of first-trimester spontaneous abortion, clinically thought to be complete. STUDY DESIGN: A prospective interventional non-randomized study was performed in a tertiary care University hospital. Sixty-two women with suspected first-trimester spontaneous abortion, clinically thought to be complete were included in the study. All women were evaluated on admission by transvaginal color Doppler ultrasonography. The amount of blood flow within the myometrium or in the endometrium-myometrium interface was assessed. Those women with suspected retained tissue on color Doppler were scheduled to undergo dilatation and curettage (D&C). Those patients with no suspected retained tissue on color Doppler were scheduled for expectant management. RESULTS: Eighteen women had suspected retained tissue and 44 women did not. A total of 16 out of 18 (88.9%) patients had retained trophoblastic tissue confirmed on histopathologic analysis. There were two false negative cases. Outcome of all patients managed expectantly was optimal with no complications. CONCLUSIONS: Transvaginal color Doppler ultrasonography is useful to detect or to rule out the presence of retained trophoblastic tissue after first-trimester spontaneous abortion and to select patients for expectant management.
Authors: Luís Guedes-Martins; Joaquim P Saraiva; Ana R Gaio; Ana Reynolds; Filipe Macedo; Henrique Almeida Journal: BMC Pregnancy Childbirth Date: 2015-02-13 Impact factor: 3.007