The reliability of ultrasonography in determining the degree of completeness of first trimester spontaneous abortion
AbstractBackground: Management of Spontaneous first trimester abortion is often based on ultrasonography findings.
Objective: To determine the reliability of ultrasonography in selecting women for uterine evacuation.
Study Design: A prospective descriptive study of women with first trimester abortion who presented at the Obstetrics and Gynecology clinics.
Materials and Methods: Ninety-five women were studied with clinical presentation of spontaneous abortion; all the women had ultrasonography, and suction curettage. The histological report was then correlated with the ultrasound findings to determine the accuracy of ultrasonography.
Results: Ultrasound classified 39 patients as having complete abortion and 56 patients had incomplete abortion. Thirty-seven of 39 patients with ultrasound finding of empty uterus showed no chorionic villi on histological examination of uterine curetting. Thus the predictive value of a negative ultrasonography was 95%. Of the 56 patients with ultrasound findings of incomplete abortion, 25 patients had retained products on ultrasonography evidenced by presence of gestational sac or echogenic mass within the uterine cavity, 24 of these women had positive confirmation of chorionic villi at histology, giving a positive predictive value for this sonographic sign of 96%. The rest 31 patients had minimal endometrial fluid collection, surrounded by thickened endometrial plate of at least 20mm in diameter, 24 had positive chorionic villi identification, giving a positive predictive value for this sign of 77%.
Conclusion: Ultrasonography is reliable in making a diagnosis of complete abortion, and thus in selecting patients for expectant management after early trimester abortion.
Keywords: ultrasonography, spontaneous abortion
Tropical Journal of Obstetrics and Gynaecology Vol. 22(2) 2005: 113-115
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