Shuchi Rodgers MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To determine if the presence of endometrial/subendometrial low resistance flow can predict retained products of conception (RPOC) Methods and Materials: Consecutive patients with excessive bleeding after spontaneous or elective abortion or vaginal delivery, who had transvaginal sonography using color and pulsed Doppler and subsequent dilatation and evacuation were reviewed. Sonography was considered positive if color flow in the endometrial/subendometrial region had a resistive index < or = 0.7. Pathology was positive for RPOC if chorionic villi were demonstrated. Endometrial stripe thickness (EMS) was measured in the sagittal view of the uterus. Statistical calculations included: sensitivity (SEN), specificity (SPE) and predictive values (PPV, NPV). ANOVA compared EMS by outcome group (TP, FP, TN) with p<.05 significant. Results: 42 patients met the inclusion criteria: 25 (clinically spontaneous abortion), 14 (elective abortion), 3 (vaginal delivery). Sonographic pathologic correlation yielded: TP 30, FP 1, TN 6 and FN 5. In percentages: SEN 85.7, SPE 85.7, PPV 96.8 and NPV 54.5. For all patients, the mean EMS was 2.0 cm, SD=1.0, range 0.7-5.0. Since cases of rare or scant chorionic villi are clinically insignificant as RPOC, when the pathologic data was reviewed and these cases considered negative, the correlation with sonography yielded: TP 26, FP 5, TN 10 and FN 1. In percentages: SEN 96.3, SPE 66.7, PPV 83.9 and NPV 90.9. The EMS data for TP was: mean=2.1, SD=0.97; for TN: mean=2.1, SD=1.1 and for FP: mean=1.6, SD=.93. The mean EMS were not statistically different among these 3 groups, (p=0.61 by ANOVA). The single FN had an EMS=1.0 cm. Conclusion: A positive Doppler result is highly sensitive for retained products of conception in a group of patients with similar endometrial stripe thickness.       Questions about this event email: horrowm@einstein.edu

Rodgers MD, S, Use of Color and Pulsed Doppler to Predict Retained Products of Conception.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3105584.html