Sonohysterography for the diagnosis of residual trophoblastic tissue.

Abstract

Sonohysterography for detection and diagnosis of residual trophoblastic tissue is an accurate and safe procedure. Further studies comparing the efficacy of sonohysterography with that of diagnostic hysteroscopy are warranted.

Analyzing the Role of Saline Infusion Sonography in the Characterization of Endometrial Pathologies

“…On SHG submucous fibroids were broad based, hypoechoic, well defined solid masses with shadowing and an overlying layer of echogenic endometrium that disorts the endometrial myometrial interface. This is comparable with the results in the study conducted by Patricia C Davis et al (6) Residual trophoblastic tissue was detected in a patient with post partum bleeding which did not respond to repeated D &Cs.SHG showed a heterogenous mass attached to emdometrial lining which correlated with study conducted by Zalel Y.et al (7) and Wolman et al (8) The major drawback of the study was that no case of endometrial carcinoma could be detected. This was probably due to the fact that only a few patients in the postmenopausal age group were included in the study.…”

Color doppler imaging in the sonohysterographic diagnosis of residual trophoblastic tissue

“…10À14 In a previous study, we evaluated the use of sonohysterography for the diagnosis of residual trophoblastic tissue before undertaking operative hysteroscopy 5 ; we found that the lesion's continued adherence to the uterine wall after introduction of fluid into the uterus was highly suggestive of residual trophoblastic tissue. However, it was still unknown whether the demonstration of blood flow within such lesions would enhance diagnostic accuracy.…”

“…5 Briefly, after the vagina and cervix were cleansed with antiseptic (Polydin solution [P.V.P.-Iodine 10%]; Fischer Pharmaceuticals, Tel-Aviv, Israel), an 8F Foley catheter with a 3-ml balloon and a plastic guide was introduced transcervically into the uterine cavity using sterile long forceps. Once the balloon was in the proper position (ie, in the cervical os), it was slowly filled with 1À2 ml of sterile saline solution.…”

“…3,4 Its main contribution for diagnosing residual trophoblastic tissue is its specificity, which has been reported to be as high as 100%. 5 Color Doppler sonographic evaluation of a suspected intrauterine echogenic mass may also help to identify the type of the mass. 5,6 The aim of this prospective cohort study was to evaluate the role of color Doppler imaging during sonohysterography in the diagnosis of residual trophoblastic tissue.…”

Accuracy of Diagnosis of Retained Products of Conception After Dilation and Evacuation

“…These procedures, however, require general anesthesia and are associated with risks (anesthesia-and procedure-related complications and endometrial adhesions) as well as considerable inconvenience for the patients. 1,5,6 Recently, transvaginal sonohysterography with removal of retained tissue under vision has gained popularity [7][8][9][10] because the ability of a regular sonographic examination to accurately detect retained products of conception has been questioned. [11][12][13] Thus, physicians caring for symptomatic patients who have undergone D&E have to rely on their clinical judgment supplemented by the limited diagnostic capabilities of the sonographic examination to decide between a surgical procedure and continuation of conservative treatment.…”