Managing patients with suspected postpartum retained products of conception using a novel sonographic classification.
Acta Radiol
; 63(3): 410-415, 2022 Mar.
Article
em En
| MEDLINE
| ID: mdl-33517665
ABSTRACT
BACKGROUND:
Suspicion of retained products of conception (RPOC) often arises after delivery and still poses a diagnostic and management challenge.PURPOSE:
To prospectively evaluate a sonographic classification for the management of patients with suspected RPOC after delivery. MATERIAL ANDMETHODS:
Based on grayscale and Doppler ultrasound parameters, patients were classified into high, moderate, or low probability of RPOC. For the low and moderate probability groups, an ultrasound follow-up at the end of the puerperium was recommended. For the high probability group, a follow-up examination was conducted 10-14 days after the first ultrasound, and patients with persistent high probability findings were referred for surgical intervention.RESULTS:
The sample was composed of 215 patients at risk of RPOC. Of these, 100, 93, and 22 patients were classified as having a low, moderate, or high probability of RPOC, respectively. Rates of RPOC were 55%, 2%, and 2% in the high, moderate, and low probability categories, respectively. When the categorization was based on the most recent ultrasound obtained during the puerperium, the adjusted RPOC prevalence rates were 71% in the high, 6% in the moderate, and 0% in the low probability groups.CONCLUSION:
This study confirms the effectiveness of our sonographic classification for managing patients with suspected RPOC after delivery. In all three categories, it is recommended to adhere to a conservative management protocol in clinically stable women until the end of the puerperium. This approach provides good predictability for RPOC and can reduce unnecessary surgical interventions.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ultrassonografia
/
Placenta Retida
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Middle aged
/
Pregnancy
Idioma:
En
Revista:
Acta Radiol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Israel