APPEARANCE OF THE UTERUS BY ULTRASOUND IMMEDIATELY AFTER PLACENTAL DELIVERY WITH PATHOLOGICAL CORRELATION

The purpose of this study was to compare the ultrasound appearance of the uterus immediately after the placenta was delivered with the gross and histologic findings obtained by manual exploration and sponge cur ettage. One hundred thirty-one patients underwent a sonographic assess ment of the uterus within 5 minutes of placental delivery. A manual ex ploration and sponge curettage were performed with 2 minutes of the ul trasound examination, and the specimens were assessed for gross and hi stologic evidence of retained products of conception. Twenty-four (18. 8%) of the patients had documented evidence of retained products of co nception either by gross inspection or histologic assessment. Nineteen (15%) of the patients had what appeared to be retained products on ul trasound examination. Using our sonographic description of retained pr oducts of conception, the sensitivity, specificity, positive predictiv e value, and negative predictive value of ultrasound in detecting reta ined products was 44%, 92%, 58%, and 87%, respectively. The ultrasound findings in patients with retained products of conception were: a nor mal endometrial cavity in 9 (37.5%), echogenic mass in 6 (25%), hetero genous mixed density mass in 5 (21%), and fluid only in 4 (16.6%). Of the 6 cases with an echogenic mass, all were associated with retained products of conception. The ultrasound appearance of retained products of conception in the immediate time period after placental delivery i s highly variable. (C) 1997 John Wiley & Sons, Inc.