Managing patients with suspected postpartum retained products of conception using a novel sonographic classification.
Classification
postpartum
retained products of conception
ultrasound
Journal
Acta radiologica (Stockholm, Sweden : 1987)
ISSN: 1600-0455
Titre abrégé: Acta Radiol
Pays: England
ID NLM: 8706123
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
pubmed:
2
2
2021
medline:
14
1
2022
entrez:
1
2
2021
Statut:
ppublish
Résumé
Suspicion of retained products of conception (RPOC) often arises after delivery and still poses a diagnostic and management challenge. To prospectively evaluate a sonographic classification for the management of patients with suspected RPOC after delivery. Based on grayscale and Doppler ultrasound parameters, patients were classified into high, moderate, or low probability of RPOC. For the low and moderate probability groups, an ultrasound follow-up at the end of the puerperium was recommended. For the high probability group, a follow-up examination was conducted 10-14 days after the first ultrasound, and patients with persistent high probability findings were referred for surgical intervention. The sample was composed of 215 patients at risk of RPOC. Of these, 100, 93, and 22 patients were classified as having a low, moderate, or high probability of RPOC, respectively. Rates of RPOC were 55%, 2%, and 2% in the high, moderate, and low probability categories, respectively. When the categorization was based on the most recent ultrasound obtained during the puerperium, the adjusted RPOC prevalence rates were 71% in the high, 6% in the moderate, and 0% in the low probability groups. This study confirms the effectiveness of our sonographic classification for managing patients with suspected RPOC after delivery. In all three categories, it is recommended to adhere to a conservative management protocol in clinically stable women until the end of the puerperium. This approach provides good predictability for RPOC and can reduce unnecessary surgical interventions.
Sections du résumé
BACKGROUND
BACKGROUND
Suspicion of retained products of conception (RPOC) often arises after delivery and still poses a diagnostic and management challenge.
PURPOSE
OBJECTIVE
To prospectively evaluate a sonographic classification for the management of patients with suspected RPOC after delivery.
MATERIAL AND METHODS
METHODS
Based on grayscale and Doppler ultrasound parameters, patients were classified into high, moderate, or low probability of RPOC. For the low and moderate probability groups, an ultrasound follow-up at the end of the puerperium was recommended. For the high probability group, a follow-up examination was conducted 10-14 days after the first ultrasound, and patients with persistent high probability findings were referred for surgical intervention.
RESULTS
RESULTS
The sample was composed of 215 patients at risk of RPOC. Of these, 100, 93, and 22 patients were classified as having a low, moderate, or high probability of RPOC, respectively. Rates of RPOC were 55%, 2%, and 2% in the high, moderate, and low probability categories, respectively. When the categorization was based on the most recent ultrasound obtained during the puerperium, the adjusted RPOC prevalence rates were 71% in the high, 6% in the moderate, and 0% in the low probability groups.
CONCLUSION
CONCLUSIONS
This study confirms the effectiveness of our sonographic classification for managing patients with suspected RPOC after delivery. In all three categories, it is recommended to adhere to a conservative management protocol in clinically stable women until the end of the puerperium. This approach provides good predictability for RPOC and can reduce unnecessary surgical interventions.
Identifiants
pubmed: 33517665
doi: 10.1177/0284185121991464
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM