ACCURACY OF TRASVAGINAL SONOGRAPHY IN DETECTING RETAINED PRODUCTS OF COCEPTION IN CORRELATION WITH PATHOLOGIC FINDINGS AND CLINICAL EXAMINATION

Abstract

OBJECTIVE: To compare the diagnostic accuracy of transvaginal sonographic versus clinical estimation in women suspected to have retained products of conception, and also characterize the sonographic appearances of retained products of conception(RPOC) in an attempt to reduce the number of unnecessary surgical interventions following evacuations. METHOD: 109 patients whom suspected to have retained products of conception based on clinical and transvaginal sonographic were studied and finally clinical and sonographic finding were compared to post evacuation histopathological reports. RESULTS: Histophathological analysis confirmed the presence of RPOC in 68 women (62.4%).The sensitivity of clinical examination was higher to ultrasound evaluation, while the specificity, PPV, NPV and diagnostic accuracy of ultrasound was higher than the clinical estimation. Mean endometrial thickness with RPOC was 14.4 versus 7.1 mm. The sensitivity and specificity of the endometrial thickness greater than 12 mm for detecting RPOC was 66.2% and 97.6% respectively. CONCLUSION: Based on our current experience, it seems, that combination of clinical data and ultrasonographic findings are more reliable for detection of RPOC and thus lowering the rate of unnecessary invasive procedures. According to this study an endometrial thickness of 12 mm or more by transvaginal sonography, has the best diagnostic accuracy for detection of RPOC. Keywords : RPOC; Retained products of conception; Transvaginal sonography