![]() ![]() Type 1: minimal endometrial vascularity less than the myometrium Three vascularity patterns have been established on Doppler ultrasound 12: Furthermore, if the endometrial thickness is less than 10 mm, there is a relatively high negative predictive value (63-80%) for RPOC 13. Retained products of conception can be suspected on ultrasound if the endometrial thickness is >10 mm following dilatation and curettage or spontaneous abortion (80% sensitive) 13. Presence of vascularity within the endometrial echogenic material supports the diagnosis but the absence of color Doppler flow has a low negative predictive value because retained products of conception may be avascular 9 In some instances, this may present as an endometrial or intrauterine mass ![]() Ultrasound is typically the first-line investigation in suspected retained products of conception:Ī variable amount of echogenic or heterogeneous material within the endometrial cavity ß-human chorionic gonadotropin ( beta-hCG) remains elevated in patients with gestational trophoblastic disease but falls to an undetectable level over 2-3 weeks, in cases of retained products. Some patients may have a fever 11.ĭifferentiation of these entities is important because retained products of conception are treated conservatively or with curettage, while gestational trophoblastic disease may require chemotherapy. RPOC complicates ~2.5% (range 1-5%) of all routine vaginal deliveries 12.Īccording to one prospective study, RPOC was present after a third-trimester delivery in ~3% of women, whereas it was diagnosed in pregnancies ending during the second and first trimesters in 40% and 17% respectively 12.Ĭommon symptoms include vaginal bleeding and abdominal or pelvic pain, similar to patients with gestational trophoblastic disease.
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