VALUE OF PELVIC ULTRASONOGRAPHY AND DOPPLER TO PREDICT RETAINED PLACENTAL FRAGMENTS AFTER MID-TRIMESTERIC ABORTIONS

Abstract

This work aimed to test the diagnostic accuracy of ultrasound and color Doppler at which we can select management of second trimesteric miscarriage either conservative or surgical by aid of ultrasound and pathology of retained products. Patients involved in this work was 88 from Ain Shams University hospital. The main complaint is vaginal bleeding or abdominal and pelvic pain after second trimester miscarriage. These patients passed through history taking, clinical examination, pelvic ultrasound, laboratory investigations, evacuation and curettage and lastly pathology for remnants of products. In conclusion, the presence of echogenic mass inside the uterus with Doppler-confirmed vascularity is highly associated with the presence of retained products of conception after second trimester abortion. The high positive yield of this investigatory tool is a fair justification of surgical intervention for evacuation of RPOC. However, absence of vascularity by color Doppler does not exclude the possibility of RPOC. It is highly recommended to perform ultrasonography and Doppler assessment as early as possible after spontaneous or medical evacuation of the uterus to avoid possible detachment of placental tissue and hence absence of vascularity. This study needs to be repeated with more experienced Doppler operators to test inter observer agreement under optimal Doppler settings in this particular situation.