In the puerperium with complications the role of sonography is extremely relevant. The distinctive importance comes from the fact that in the puerperium mostly we decide about the usage of conservative therapy or surgical resection based on ultrasonography as the most informative examination procedure. The role of the diagnostic with ultrasonography is to exclude the possibility of retained placental tissue. In delivery, after the removal of the placenta and during its macroscopic examination, the retained placental tissue might not be observed. In the case of these women, the existence of placental residuals may be signaled by bleeding even after a few hours, days or 1-2 weeks without problems. The infection with retained placental tissue may lead to endomiometritis or even to sepsis. In our study we attempt to confirm or to exclude the suspicion of the retained placental tissue with the help of gray-scale ultrasonography. The blood accumulated in the uterine cavity, necrotical decidua and the intrauterine air are often assessed as a false positive case. Using the examination with the color and spectral Doppler, in case if there was residue near the suspicious area we found a clear vascular density, but the disadvantage of these characteristics is that semiquantitative data are less objectifiable. Similarly, in case of residue existence because of the persistent peritrophoblastic flow in the spiral arteries of the miometrium, in the vessels of the endometrium, and even in the uterine artery the flow parameters were different, the index of pulse waves is significantly lower. Using both methods together the recognition of the retained placental tissue is obviously more effective, thereby the possibility of wrong diagnoses can be diminished and the aimless surgical intervention may be avoided.
Keywords: pathological puerperium, retained placental tissue, ultrasound examination