超声对中晚孕分娩后胎物残留的诊断价值

目的 探讨超声对中晚孕分娩后胎物残留的诊断价值。方法 对中晚孕分娩后疑有胎物残留的186例患者进行盆腔或经阴道超声检查，分析超声表现，并与病理及临床随访对照。结果 186例患者中，为判定有无胎物残留诊刮37例，其中，30例经病理证实有胎物残留，7例无胎物残留；149例未诊刮，采用临床随访或保守治疗。子宫内膜团块是胎物残留最敏感、最特异的超声表现，其敏感性为83％，特异性为92％。宫腔积液和宫内膜增厚的敏感性较低，分别为17％和10％。胎物残留患者无1例具有正常的超声表现。结论 子宫内膜团块是诊断和排除胎物残留最敏感、最特异的超声表现；超声检查正常可以排除胎物残留。

Ultrasonography for the retained products of conception after delivery at second or three-trimester of gestation

Objective To discuss the usefulness of uhrasonography for detecting the retained products of conception（RPOCs）after delivery at second-or three-trimester of gestation. Methods A hundred and eighty-six patients with clinically suspected RPOCs after delivery at second-or three-trimester of gestation underwent pelvic-or transvaginal ultrasonography. The ultrasonic findings in all patients were compared with those of pathology and chinical follow up. Results Among 186 cases, 37 patients underwent curettage to identify whether the presence of RPOCs, of whom, 30 patients had RPOCs confirmed by pathology and 7 patients had no RPOCs, while remaining 149 patients without curettage underwent clinic follow-up and conservative treatment. An endometrial mass was the most sensitive（83% ） and specific（92% ）sonographic feature for RPOCs. The sonographic findings of the fluid in uterine cavity and endometrial thickening had low sensitivity for identifying RPOCs, which was 17% and 10% , respectively. None of patient with RPOCs had normal sonographic findings. Conclusion An endometrial mass is the most sensitive and specific sonographic finding for RPOCs. If sonographic findings are normal, RPOCs can be excluded.