EP20.18: The key role of ultrasound examinations in the diagnosis of retained product of conception

Retained product of Conception (RPOC) refers to placenta and/or fetal tissue retained in the uterus after spontaneous abortion, termination of pregnancy, spontaneous or Caesarean delivery. Vaginal bleeding is the main symptom, but other symptoms such as uterine tenderness, pelvic pain and fever may also be associated with infection. Sonographic diagnosis of RPOC is based on the presence of remnant tissue in the uterine cavity presented as an echogenic mass during an ultrasound scan. Both the residual tissue and the implantation site may have strong vascularization, which can be an important differential diagnostic criterion to distinguish it from the coagulum remaining in the uterine cavity using Doppler technology. However, the definitive diagnosis is made by histopathological examination of the residual tissue. For the physical removal of residual tissue after pregnancy, as well as for the diagnosis and treatment of intrauterine lesions, hysteroscopy is considered the gold standard procedure. However, the most widely used procedure is the dilatation and curettage method, which, due to the focal nature of the RPOC and the blinded nature of the procedure, has the potential for incomplete evacuation of the uterus (20.8% residual rate). The hysteroscopic treatment of RPOC using a resectoscope, with or without an electric one, is a feasible, safe, and effective technique. It prevents damage to the surrounding healthy uterine lining and clearly reduces the incidence of complications such as intrauterine adhesions, the development of secondary infertility or incomplete removal of residual tissue. With our work we would like to present our cases through sonographic and hysteroscopic diagnosis. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.