Characteristics and Diagnostic Accuracy of Retained Products of Conception After Delivery vs. Abortion: A...

We aimed to evaluate and compare the characteristics, clinical presentations, sonographic features, and hysteroscopic complications of retained products of conception (RPOC) after delivery versus abortion and to compare the accuracy of diagnosing RPOC in these two conditions.

This retrospective cohort study included 226 women aged 17-50 years who underwent hysteroscopy for suspected RPOC following spontaneous or induced abortion or delivery between 2018 and 2021. The diagnosis was based on a routine ultrasound, with a hysteroscopy conducted within one week. Collected data encompassed demographics, obstetric history, sonographic findings, clinical features, operative details, and pathology reports.

Of the 226 women included, 65 (28.8%) had RPOC post-delivery and 161 (71.2%) post-abortion. While age and parity did not differ significantly between the groups, gravidity was higher, and previous abortions were more common among the women post-abortion. Symptomatic presentation differed; bleeding and pain were more common post-delivery, and asymptomatic presentation was more frequent post-abortion. Sonographically, Doppler flow was more prevalent post-abortion. The optimal endometrial thickness cutoffs for predicting RPOC post-abortion and post-delivery were 1.55 and 1.49 cm, respectively.

Our study found significant differences in clinical and sonographic characteristics between women with RPOC after abortion versus delivery, emphasizing the importance of tailored diagnostic and management strategies. Although detection rates and sonographic findings varied, routine sonographic assessment is crucial, especially post-abortion. Endometrial thickness proved a reliable predictor for RPOC in both groups.