TRANSVAGINAL SONOHYSTEROGRAPHY FOR THE EARLY DIAGNOSIS OF RESIDUAL TROPHOBLASTIC TISSUE

We prospectively evaluated 29 patients with early postabortion or post partum bleeding, suspected of having possible retained trophoblastic t issue by transvaginal sonography and transvaginal sonohysterography. A ll patients received methylergometrine maleate (Sandoz) and amoxicilli n and clavulinic acid (Pharmascope) orally for 5 days and were then re evaluated. Ten patients (34.5%) had a normal uterine cavity on both tr ansvaginal sonography and sonohysterograhy. Nineteen patients (65.5%) were suspected of having residual trophoblastic tissue by transvaginal sonography. Of these, five (26%) showed normal uterine cavity by sono hysterography. One patient (8.3%) reported heavy bleeding with clots a fter the conservative treatment. Repeated examination revealed normal uterine cavity. The remaining patients underwent curettage, and histop athologic examination revealed trophoblastic tissue. Transvaginal sono hysterography is more accurate than transvaginal sonography for diagno sing residual trophoblastic tissue in patients with postpartum and pos tabortion bleeding. Its use may eliminate unnecessary curettage proced ures.