THE USE OF TRANSVAGINAL ULTRASOUND IN THE MANAGEMENT OF EARLY-PREGNANCY LOSS

Objective: The aim of the study was to determine the relationship betw een findings on transvaginal ultrasound documenting early pregnancy fa ilure and patient outcome with either expectant or surgical management . Methods: One hundred fifty-four patients were recruited following tr ansvaginal ultrasounds that revealed early pregnancy failure. Results were reported to the attending physician who made management decisions regarding dilatation and curettage or expectant management. Outcome d ata were collected by telephone interview and results were compared wi th the initial ultrasounds which were classified according to the appe arance of the tissue remaining within the endometrial cavity. Results: Management by dilatation and curettage was significantly related to u ltrasound category (p = 0.0001). There was a significant association b etween prolonged bleeding (>7 days) and ultrasound type (p = 0.041) re gardless of management method (p = 0.041). In the conservatively manag ed group there were five pregnancies reported in the follow-up period, whereas there were none in the surgically managed group (p = 0.052) C onclusions: This study reveals that physicians are using transvaginal ultrasound findings to guide them in their management of early failed pregnancies; however, the outcome data reveal that there is no signifi cant difference in the rate of prolonged bleeding, endometritis, or re peat dilatation and curettage with either method of management. Ultras ound findings appear to be predictive in terms of the rate of prolonge d bleeding, and could be used as a prognosticator rather than as a gui de for management decisions. Pregnancy rate may be increased in those managed conservatively following early pregnancy loss.