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孕中期药物流产后无症状女性子宫的超声特征

Sonographic characteristics of the uterus in asymptomatic women after second-trimester medical termination of pregnancy.

作者信息

Cheung Ka Wang, Ngu Siew-Fei, Cheung Vincent Y T

机构信息

Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, Hong Kong.

出版信息

J Ultrasound Med. 2015 Apr;34(4):611-6. doi: 10.7863/ultra.34.4.611.

Abstract

OBJECTIVES

The purpose of this study was to evaluate the sonographic characteristics of the uterus after apparently uncomplicated second-trimester medical termination of pregnancy and to follow the evolution of these findings until the return of menstruation.

METHODS

Twenty-three women who requested termination of pregnancy at gestational ages between 14 and 20 weeks were recruited. Uterine characteristics were measured by 2- and 3-dimensional transvaginal with or without transabdominal sonography. The uterine anteroposterior diameter, length, and width, endometrial thickness, presence of an endometrial mass, intrauterine vascularity, and endometrial volume were measured within 24 hours, 1, 2, 4, 6, and 8 weeks after termination, and during the postmenstrual phase.

RESULTS

The mean uterine anteroposterior diameter, uterine length, uterine width, endometrial thickness, and endometrial volume ± SD deceased gradually from 66.1 ± 9.7 to 40.9 ± 5.3 mm, 131.4 ± 14.7 to 81.3 ± 13.8 mm, 84.6 ± 10.3 to 54.2 ± 7.6 mm, 25.6 ± 8.1 to 4.5 ± 2.6 mm, and 39.4 ± 22.6 to 2.5 ± 2.1 mL, respectively, from within 24 hours after termination to the postmenstrual phase. Endometrial masses were identified in 8 women (34.8%) within 4 weeks after termination, which could persist for up to 8 weeks. However, all endometrial masses resolved after menstruation. Minimal and moderate endometrial vascularity was detectable in up to 21.7% after termination; none was detectable in any women after menstruation.

CONCLUSIONS

This study provides information on the normal sonographic parameters of the uterus after second-trimester medical termination of pregnancy, which has been lacking in the literature. Also, our findings suggest that all endometrial masses regress with time; therefore, asymptomatic women with an incidental finding of an endometrial mass can be followed without the need for an immediate intervention.

摘要

目的

本研究的目的是评估孕中期药物流产后子宫的超声特征,并追踪这些发现直至月经恢复。

方法

招募了23名在孕14至20周之间要求终止妊娠的妇女。通过二维和三维经阴道超声检查,必要时联合经腹超声检查来测量子宫特征。在终止妊娠后24小时内、1周、2周、4周、6周、8周以及月经后期测量子宫前后径、长度、宽度、子宫内膜厚度、子宫内膜肿块的存在、子宫内血管情况以及子宫内膜体积。

结果

从终止妊娠后24小时内到月经后期,子宫前后径、子宫长度、子宫宽度、子宫内膜厚度以及子宫内膜体积的平均值±标准差分别从66.1±9.7毫米逐渐减小至40.9±5.3毫米、从131.4±14.7毫米逐渐减小至81.3±13.8毫米、从84.6±10.3毫米逐渐减小至54.2±7.6毫米、从25.6±8.1毫米逐渐减小至4.5±2.6毫米、从39.4±22.6毫升逐渐减小至2.5±2.1毫升。8名妇女(34.8%)在终止妊娠后4周内发现有子宫内膜肿块,这些肿块可持续长达8周。然而,所有子宫内膜肿块在月经后均消失。终止妊娠后高达21.7%的妇女可检测到少量和中等程度的子宫内膜血管;月经后在任何妇女中均未检测到。

结论

本研究提供了孕中期药物流产后子宫正常超声参数的相关信息,这在文献中一直缺乏。此外,我们的研究结果表明,所有子宫内膜肿块会随时间消退;因此,偶然发现子宫内膜肿块的无症状妇女可以进行随访,无需立即干预。

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