Postabortion Doppler evaluation of the uterus: incidence and causes of myometrial hypervascularity
Müngen, E.üm.; Dundar, O.ür.; Babacan, A.
Journal of Ultrasound in Medicine Official Journal of the American Institute of Ultrasound in Medicine 28(8): 1053-1060
2009
ISSN/ISBN: 1550-9613 PMID: 19643788 DOI: 10.7863/jum.2009.28.8.1053Document Number: 207788
The aim of this study was to investigate the incidence and causes of uterine hypervascular lesions showing low-impedance, high-velocity flow on color Doppler sonography (CDS) after first-trimester dilation and curettage (D&C). This was a prospective study of 65 consecutive women who underwent first-trimester termination of pregnancy. Color Doppler sonography of the uterus was performed on days 3 and 10 after D&C. If the myometrial hypervascularity (MH) persisted on day 10, a second D&C was performed, and then the patients were followed with weekly Doppler examinations. In 16 of 65 women (24.6%), MH was detected with CDS on day 3 after D&C. In 3 cases, MH resolved spontaneously by postabortion day 10. In the remaining 13 patients, the second D&C performed on day 10 revealed retained products of conception (RPOC) in 8 patients (61.5%), a hydatidiform mole in 2 (15.4%), endometritis in 1 (7.7%), and no abnormality in 2 (15.4%). Complete resolution of the MH occurred in all cases. The mean period to the resolution of MH after the second D&C +/- SD was 16.54 +/- 11.06 days (range, 7-48 days). Univariate analysis revealed that gestational age at D&C (P = .012) and a history of any uterine surgery (P = .044) were significantly associated with postabortion MH. On binary logistic regression analysis, gestational age at D&C was the only independent predictive factor for MH (P = .016; odds ratio, 1.47; 95% confidence interval, 1.08-2.02). The presence of hypervascular areas within the myometrium is a common finding in the postabortion period, and in most cases, the cause of this finding is RPOC.