Sonographic evaluation of residual trophoblastic tissue in the puerperium

Written by Bereczky Lujza-Katalin, Szabó Béla, Puşcaşiu Lucian, Kiss Szilárd-Leó, Turós János-Levente, Kraft Hunor-Norbert

In the puerperium the remaining placental tissue diagnosis is a great challenge, in which the ultrasound diagnostics has a major role. Non-invasive manner, as the most informative method of analysis will help to recognize the maternal medical conditions, namely retained placental tissue can lead to postpartum haemorrhage, infection and even septic conditions. In the maternal disease states - in most cases based on ultrasound - we decide the important issue if conservative therapy or surgical intervention is the best solution. The aim of our paper is to compare the gray-scale ultrasound diagnostic accuracy and the colour spectrum Doppler examination in cases where retained placental tissue is suspected. Using the first procedure, the blood accumulation in the uterine cavity, necrotical decidua and intrauterine air often arouse suspicions of retention of placental tissue, while with the Doppler ultrasound test we found pronounced vascular density near the suspicious area, respectively altered circulatory parameters in the uterine artery. When placental tissue retention is suspected, these tests should be performed prior to uterine evacuation, since these methods can reduce unnecessary invasive procedures.

 

Keywords: puerperium, retained placental tissue, ultrasound examination


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