Appearance of the uterus by ultrasound immediately after placental delivery with pathologic correlation

Carlan, S. J.; Scott, W. T.; Pollack, Robert S.; Harris, Karen

doi:10.1002/(sici)1097-0096(199707)25:6<301::aid-jcu3>3.0.co;2-g

Cited by 48 publications

(50 citation statements)

References 5 publications

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“…2,5,6 The presence of calcified and uncalcified placental tissue, blood clots, and necrotic decidua in varying amounts leads to overlap of findings in patients with and without retained products. 6,8 It is because of this variability in appearance that our study was undertaken in patients after a second-or third-trimester delivery. All patients with a first-trimester spontaneous or therapeutic abortion were excluded from the study.…”

Section: Discussionmentioning

confidence: 99%

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The Sonographic and Color Doppler Features of Retained Products of Conception

Durfee

Frates

Luong

et al. 2005

Journal of Ultrasound in Medicine

108

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Objective. The purpose of this study was to identify the sonographic features of retained products of conception (RPOCs). Methods. Cases of clinically suspected RPOCs referred for pelvic sonography between September 1994 and July 2001 were identified. Patient age, indication, gestational age at delivery, and days postpartum were recorded and sonographic findings were reviewed. Outcomes were determined from medical records and pathology reports. Results. One hundred sixty-three cases were identified. Indications for pelvic sonography included vaginal bleeding in 82 (50%), pelvic pain in 77 (47%), and fever in 55 (34%). Gestational age at delivery ranged from 14 to 43 weeks (mean, 37 weeks), and the sonographic examination was performed from 0 to 95 days postpartum (mean, 21 days). Thirty-six patients underwent surgical intervention, and 28 of these had RPOCs. The remaining 127 patients were followed clinically. An endometrial mass was the most sensitive (79%) and specific (89%) sonographic feature for RPOCs. The isolated finding of either complex fluid in the endometrial canal or a thick endometrium measuring greater than 10 mm had low sensitivity, specificity, and negative and positive predictive values. None of the patients with RPOCs had normal sonographic findings. The absence of an endometrial mass or complex fluid and an endometrial thickness of less than 10 mm were considered normal findings. Color Doppler flow was detected in the endometrium somewhat more often when RPOCs were present than in the absence of RPOCs (75% versus 40%). Conclusions. An endometrial mass is the most sensitive finding for RPOCs. If no mass or endometrial fluid is seen and the endometrial thickness is less than 10 mm, RPOCs are extremely unlikely. The absence of blood flow does not exclude the diagnosis of RPOCs.

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Section: Discussionmentioning

confidence: 99%

“…Patients with RPOCs, however, have a more varied appearance on sonography, with variable sensitivities (44%-93.8%) and specificities (73.9%-92%) reported. 2,7,8 We conducted this study to assess the accuracy of transabdominal and transvaginal sonography for diagnosing and excluding RPOCs in patients after secondand third-trimester deliveries.…”

mentioning

confidence: 99%

The Sonographic and Color Doppler Features of Retained Products of Conception

Durfee

Frates

Luong

et al. 2005

Journal of Ultrasound in Medicine

108

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“…They have proposed three uterus types: Empty uterus, cavity filled with clots or blood, uterus with echogenic areas that represent the residual placental tissue (Lipinski and Adam, 1981). Carlan et al (1997) have been explained residual products of pregnancy immediately after discharge of placenta. Sokol et al (2004) were discussed the ultrasound results at 48 h after normal delivery, in which they have observed inter-cavity echogenicity in 40% of asymptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

Structural and Anatomic Characteristics of the Uterus at 7-10 and 30-40 Days After Cesarean Section

Barati¹,

Zarei²,

Masihi³

et al. 2015

Asian J. of Epidemiology

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This study was conducted with the purpose of presenting normal uterus ultrasonographic findings at the 7-10 and 30-40 days after an uncomplicated caesarean section. Abdominal ultrasound was performed on women who underwent cesarean section with the lower segment incision in 222 women at 7-10 and 106 women at 30-40 days after operation. Uterine dimension was measured presences of echo-free fluid, echogenicity of uterine cavity and echogenicity on uterus scar were studied. The uterus length, width and endometrial thickness were 130±20, 59±12 and 6.4±3 mm at 7-10 days after operation, respectively. The uterus length, width and endometrial thickness were 88±20, 46±14, 5.0±3 mm at 30-40 days after surgery, respectively. In 7-10 and 30-40 days after cesarean, echo-free fluid accumulation were observed in 68 (28.6) and 11 (9.6%) of women, echogenicity of intra-uterine cavity were seen in 40 (16.8) and 5 (4.3%) women, echogenicity in the scar area were seen in 102 (42.9) and 38 (33%) of participants, respectively. Pelvic ultrasound is applicable during the postpartum period. Presence of echogenicity and echo-free fluid within the uterine cavity and echogenicity of scar region are repeated finding in patients who are clinically stable.

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“…16 Following histological assessment of the intrauterine material, the sensitivity, specificity, positive and negative predictive value of ultrasound in detecting retained products in their study was 44%, 92%, 58% and 87%, respectively. Of those patients with histologically confirmed retained products of conception, the majority in fact had a normal endometrial cavity on ultrasound scan (37.5%).…”

Section: Ultrasound Appearances Immediately Postpartum (Within 24 Hours)mentioning

confidence: 99%

The postpartum ultrasound scan

Ucyigit

Johns

2016

Ultrasound

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Ultrasound assessment of the postpartum uterus has a significant role to play in the evaluation of a large proportion of symptomatic puerperal women. Often the imaging modality of choice for excluding retained placental tissue, correct application of postpartum ultrasound could enable more accurate identification of women requiring surgical intervention, with consequent reduction in patient morbidity and clinical workload. This article aims to review the current understanding and application of ultrasound in the puerperium and evaluate the current evidence investigating the physiological and pathological findings of the postpartum uterus and its contents. KeywordsPostpartum, puerperium, ultrasound appearances, uterus Date received: 28 February 2016; accepted: 11 May 2016 BMUS members can earn 1 CPD point by reading this approved CPD article and successfully completing the online test. Please go to the members' area of the BMUS website (www.bmus.org) and log into the BMUS CPD system.

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Appearance of the uterus by ultrasound immediately after placental delivery with pathologic correlation

Cited by 48 publications

References 5 publications

The Sonographic and Color Doppler Features of Retained Products of Conception

The Sonographic and Color Doppler Features of Retained Products of Conception

Structural and Anatomic Characteristics of the Uterus at 7-10 and 30-40 Days After Cesarean Section

The postpartum ultrasound scan

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