Matijevic Ratko, Knezevic Mario, Grgic Ozren, Zlodi-Hrsak Lana
Department of Obstetrics and Gynecology, University of Zagreb, School of Medicine, Zagreb, Croatia.
J Ultrasound Med. 2009 Mar;28(3):295-9. doi: 10.7863/jum.2009.28.3.295.
The purpose of this study was to assess the diagnostic accuracy of different parameters (clinical and sonographic) in the prediction and management of retained products of conception (RPOC) in the late postpartum period.
This was a prospective cohort 3-year audit. Predefined data were collected and compared with histopathologic (HP) reports after uterine evacuation. The primary outcome measure was the diagnostic accuracy of different clinical and sonographic parameters, including color Doppler imaging in diagnosis of RPOC confirmed on HP reports. Secondary outcome measures were complication rates influencing maternal morbidity.
In total, 93 patients (0.92% of all deliveries) were selected. The presence of gestational tissue was confirmed on HP reports in 58% of cases. The likelihood ratio of sonography alone was 1.47 (95% confidence interval, 1.25-1.84), whereas that of sonography combined with color Doppler imaging was 2.16 (1.3-3.59), providing statistically significant accuracy regarding the prediction of RPOC.
Sonography alone or combined with color Doppler imaging has better diagnostic accuracy than the usual clinical parameters used for the prediction of RPOC.
本研究旨在评估不同参数（临床和超声）在预测和处理产后晚期妊娠物残留（RPOC）中的诊断准确性。
这是一项为期3年的前瞻性队列审计。收集预先定义的数据，并与子宫排空后的组织病理学（HP）报告进行比较。主要结局指标是不同临床和超声参数的诊断准确性，包括彩色多普勒成像对HP报告中确诊的RPOC的诊断准确性。次要结局指标是影响孕产妇发病率的并发症发生率。
总共选择了93例患者（占所有分娩的0.92%）。HP报告证实58%的病例存在妊娠组织。单纯超声检查的似然比为1.47（95%置信区间，1.25 - 1.84），而超声检查结合彩色多普勒成像的似然比为2.16（1.3 - 3.59），在预测RPOC方面具有统计学上显著的准确性。
单纯超声检查或联合彩色多普勒成像在预测RPOC方面比常用的临床参数具有更好的诊断准确性。
