Sonohysterography for the diagnosis of residual trophoblastic tissue

Objective. To assess the efficacy, safety, and associated complications of sonohysterography for the diagnosis of residual trophoblastic tissue. Metho ds. We conducted a prospective study of 23 consecutive patients admitted to our ultrasonography unit with clinical and ultrasonographic signs of retai ned intrauterine tissue. Results. Twelve patients had hydrosonographic feat ures suggestive of residual trophoblastic tissue (i.e., an intrauterine les ion not detachable from the uterine wall after instillation of saline), whe reas in 11 cases the hydrosonographic findings were negative for retained t issue. Blood flow was detected within abnormal intrauterine masses in 4 of 12 patients with trophoblastic tissue, whereas it was not detected in any p atient without retained tissue (P =.093). No complications were encountered during the procedure or the postprocedure period. None of the patients had anesthetic complications, perforation of the uterus, fluid overload, or an y other surgical complication. All 12 patients underwent hysteroscopic remo val of the suspected residual trophoblastic tissue, and histologic confirma tion of residual trophoblastic tissue was obtained in all cases. Conclusion s. Sonohysterography for detection and diagnosis of residual trophoblastic tissue is an accurate and safe procedure. Further studies comparing the eff icacy of sonohysterography with that of diagnostic hysteroscopy are warrant ed.