Jl. Alcazar, TRANSVAGINAL ULTRASONOGRAPHY COMBINED WITH COLOR VELOCITY IMAGING ANDPULSED DOPPLER TO DETECT RESIDUAL TROPHOBLASTIC TISSUE, Ultrasound in obstetrics & gynecology, 11(1), 1998, pp. 54-58
Citations number
13
Categorie Soggetti
Acoustics,"Obsetric & Gynecology","Radiology,Nuclear Medicine & Medical Imaging
The value of transvaginal B-mode ultrasonography combined with color v
elocity imaging and pulsed Doppler to detect retained trophoblastic ti
ssue was evaluated prospectively in a series of 40 patients with postp
artum (n = 15) or postabortion (n = 25) bleeding. Color velocity imagi
ng was wed to identify color-coded blood flow signals within myometriu
m and/or endometrium. Flow was subjectively quantified as absent, scan
ty or abundant. Pulsed Doppler was used to assess blood flow impedance
by calculating the resistance index. The presence of abundant flow wi
th a lowest resistance inner of less than 0.45 was considered as suspi
cious of residual trophoblastic tissue. Twenty-two (55%) out of the 40
patients underwent dilatation and curettage and chorionic villi were
demonstrated in 15 of these. Eighteen (45%) patients were managed cons
ervatively. None of these patients suffered complications or needed re
admission for currettage, and all of them were considered as not havin
g retained tissue. On color pulsed Doppler ultrasound examination, 15
patients had suspected retained tissue; all of these underwent curetta
ge and residual trophoblast was found in 14 (93.3%). Out of 25 patient
s considered as having no residual tissue on color pulsed Doppler ultr
asound examination, seven underwent curettage and chorionic villi were
found in one patient (false-negative rate 6.7%) All patients managed
conservatively had an unsuspicious scan. We concluded that transvagina
l ultrasonography combined with color velocity imaging and pulsed Dopp
ler could be useful to detect retained trophoblastic tissue and to sel
ect patients suitable for conservative management.