Sadan Oscar, Golan Abraham, Girtler Ofer, Lurie Samuel, Debby Abraham, Sagiv Ron, Evron Shmuel, Glezerman Marek
Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel.
J Ultrasound Med. 2004 Mar;23(3):371-4. doi: 10.7863/jum.2004.23.3.371.
To present our experience with clinical and sonographic diagnosis of retained products of conception and to evaluate its correlation with histopathologic findings.
This was a retrospective study on 156 patients admitted for retained products of conception. Women were referred because of 1 or more of the following: abdominal pain, bleeding, and fever. The status of the cervix was evaluated by bimanual examination. The diagnosis of retained products of conception was made when a sonographic finding of hyperechoic or hypoechoic material was seen in any part of the uterine cavity or the presence of a thickened endometrial stripe greater than 8 mm and an irregular interface between the endometrium and myometrium was found. One hundred twenty-one women (77.6%) were admitted after dilation and curettage for abortion, and 35 (22.4%) were admitted after spontaneous labor.
Histopathologic reports confirmed the diagnosis of retained products of conception in 86 (71%) of 121 women in the postabortion group and in 17 (48.5%) of 35 women in the postpartum group. The overall false-positive rate for sonographic diagnosis was 34%. For women after abortion and after delivery, the false-positive rates were 28.9% and 51.5%, respectively.
Reliance on common signs and symptoms to diagnose retained products of conception as well as the use of sonography is associated with an unacceptably high false-positive rate, mainly after delivery. A more conservative approach to the treatment of retained products of conception is suggested.
介绍我们在诊断妊娠物残留的临床及超声检查方面的经验，并评估其与组织病理学结果的相关性。
这是一项对156例因妊娠物残留入院患者的回顾性研究。患者因以下一种或多种情况前来就诊：腹痛、出血和发热。通过双合诊评估宫颈情况。当超声检查发现宫腔内任何部位有高回声或低回声物质，或子宫内膜厚度大于8mm且子宫内膜与肌层之间界面不规则时，诊断为妊娠物残留。121名女性（77.6%）在人工流产刮宫术后入院，35名女性（22.4%）在自然分娩后入院。
组织病理学报告证实，人工流产后组121名女性中有86名（71%）、产后组35名女性中有17名（48.5%）诊断为妊娠物残留。超声诊断的总体假阳性率为34%。人工流产后及分娩后的女性，假阳性率分别为28.9%和51.5%。
依赖常见体征和症状以及超声检查来诊断妊娠物残留，假阳性率高得令人难以接受，主要是在分娩后。建议对妊娠物残留采取更保守的治疗方法。
