Transvaginal Sonohysterography for the Evaluation and Treatment of Retained Products of Conception

Abstract

Diagnosing retained products of conception in a woman presenting with postpartum or postabortion bleeding presents a clinical challenge. Although ultrasonographic examination may be potentially useful in detecting retained products of conception, its accuracy has not yet been established. Saline infusion sonohysterography is a simple ultrasonographic technique for enhanced transvaginal sonographic imaging of the endometrial cavity by the instillation of saline into the uterine cavity during ultrasonographic evaluation. This technique enhanced our ability to diagnose retained products of conception, and we describe our experience in evacuating them under sonographic guidance while performing saline infusion sonohysterography.

Color doppler imaging in the sonohysterographic diagnosis of residual trophoblastic tissue

“…Although sonohysterography alone was previously shown to have high specificity and sensitivity for the detection of residual trophoblastic tissue, 5,16 the demonstration by color Doppler imaging of blood flow in the intrauterine solid masses had a 100% specificity for the diagnosis of residual trophoblastic tissue. Tal et al 6 also found that the use of color Doppler imaging during sonohysterography significantly increased the diagnostic accuracy in 4 cases.…”

Asherman syndrome—one century later

“…Although ultrasonographic examination may be potentially useful, its accuracy has not yet been established. Saline infusion sonohysterography has enhanced our ability to diagnose retained products of conception (126). Alcazar (127) tried transvaginal B-mode ultrasonography combined with color velocity imaging and pulsed Doppler to detect retained trophoblastic tissue and concluded that this investigation could be useful to detect retained trophoblastic tissue and to select patients suitable for conservative management.…”

Variable color Doppler sonographic appearances of retained products of conception: radiologic-pathologic correlation

“…Retained products of conception (RPOC) occurs following parturition or termination of pregnancy in nearly 1 percent of all pregnancies [1]. The incidence of RPOC is the highest after termination of pregnancy and second-trimester deliveries [2].…”