Cetin A, Cetin M
Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey.
Contraception. 1998 Jun;57(6):393-7. doi: 10.1016/s0010-7824(98)00046-8.
The purpose of this study was to evaluate the diagnostic accuracy of transvaginal sonography for first trimester spontaneous abortions, thought to be incomplete or complete, in patients with postabortion bleeding or uterine cramping within 5 days of abortion. In a prospective study, 78 patients underwent transvaginal sonography to evaluate the maximum anteroposterior diameter of the uterine cavity on the long axis view and echo pattern of the retained products of conception. Patients were divided into three groups: those with a normal uterine cavity or a uterine cavity with fluid collection without echogenic foci (n = 13, group A), those with a uterine cavity containing fluid mixed with solid components (n = 38, group B), and those with a uterine cavity containing solid components (n = 27, group C). Group A was considered not to have retained products of conception, and the latter two groups were considered to have retained products of conception. Patients in group A were assigned to receive conservative treatment. In groups B and C, patients with significant vaginal bleeding during 48 h of follow-up underwent elective curettage and those with minimal-mild bleeding received conservative management. A total of 73 patients (12 in group A, 35 in group B and 26 in group C) completed the study. There were no differences in any of selected reproductive data of the groups (p > 0.05). In group B, all patients with uterine cavity diameter of 10 mm or greater underwent elective curettage. In group C, all patients with a diameter of the uterine cavity 8 mm or greater underwent elective curettage. The overall complication and patient satisfaction rates were approximately 14% and 88%, respectively. Transvaginal sonographic findings can be used as a decision factor in the management of patients with first trimester spontaneous abortion to reduce the need for an elective curettage by approximately 58%.
本研究的目的是评估经阴道超声检查对流产后5天内出现流产后出血或子宫绞痛、被认为是不全流产或完全流产的孕早期自然流产患者的诊断准确性。在一项前瞻性研究中，78例患者接受经阴道超声检查，以评估子宫腔长轴视图上的最大前后径以及残留妊娠产物的回声模式。患者被分为三组：子宫腔正常或有液性暗区且无回声灶的患者（n = 13，A组），子宫腔内含有液性和实性成分混合的患者（n = 38，B组），以及子宫腔内含有实性成分的患者（n = 27，C组）。A组被认为没有残留妊娠产物，后两组被认为有残留妊娠产物。A组患者接受保守治疗。在B组和C组中，随访48小时内阴道出血明显的患者接受选择性刮宫术，出血轻微的患者接受保守治疗。共有73例患者（A组12例，B组35例，C组26例）完成了研究。各组所选生殖数据均无差异（p>0.05）。在B组中，所有子宫腔直径≥10 mm的患者均接受了选择性刮宫术。在C组中，所有子宫腔直径≥8 mm的患者均接受了选择性刮宫术。总体并发症发生率和患者满意率分别约为14%和88%。经阴道超声检查结果可作为孕早期自然流产患者管理的决策因素，以将选择性刮宫术的需求减少约58%。
