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Retained Products of Conception
Anne Kennedy, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Retained products of conception (RPOC)
            • Definitions

              • RPOC: Incomplete uterine evacuation with retained placental/trophoblastic tissue in endometrial cavity
                • Seen after abortion, vaginal delivery, cesarean section
              • Enhanced myometrial vascularity (EMV): Descriptive term for low-resistance waveforms of variable velocity spanning full myometrial thickness
                • Common, seen in 50% of asymptomatic patients on postpartum day 3
                • Seen with RPOC, gestational trophoblastic disease, placental site subinvolution, arteriovenous malformation

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • MR Findings

                  DIFFERENTIAL DIAGNOSIS

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              • Image Interpretation Pearls

                                Selected References

                                1. Wang SS et al: Imaging of postpartum/peripartum complications. Radiol Clin North Am. 58(2):431-43, 2020
                                2. Groszmann YS et al: Diagnosis and management of patients with enhanced myometrial vascularity associated with retained products of conception. Ultrasound Obstet Gynecol. 52(3):396-9, 2018
                                3. Iraha Y et al: Multimodality imaging in secondary postpartum or postabortion hemorrhage: retained products of conception and related conditions. Jpn J Radiol. 36(1):12-22, 2018
                                4. Phillips CH et al: First-trimester emergencies: a radiologist's perspective. Emerg Radiol. 25(1):61-72, 2018
                                5. Kamaya A et al: Clinical and imaging predictors of management in retained products of conception. Abdom Radiol (NY). 41(12):2429-34, 2016
                                6. Kamaya A et al: Variable color Doppler sonographic appearances of retained products of conception: radiologic-pathologic correlation. Abdom Imaging. 40(7):2683-9, 2015
                                7. Ben-Ami I et al: A comparison of reproductive outcomes following hysteroscopic management versus dilatation and curettage of retained products of conception. Int J Gynaecol Obstet. 127(1):86-9, 2014
                                8. Smorgick N et al: Hysteroscopic management of retained products of conception: meta-analysis and literature review. Eur J Obstet Gynecol Reprod Biol. 173:19-22, 2014
                                9. Atri M et al: Best predictors of grayscale ultrasound combined with color Doppler in the diagnosis of retained products of conception. J Clin Ultrasound. 39(3):122-7, 2011
                                10. Kitahara T et al: Management of retained products of conception with marked vascularity. J Obstet Gynaecol Res. 37(5):458-64, 2011
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Clinical Issues

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Abbreviations

                                            • Retained products of conception (RPOC)
                                          • Definitions

                                            • RPOC: Incomplete uterine evacuation with retained placental/trophoblastic tissue in endometrial cavity
                                              • Seen after abortion, vaginal delivery, cesarean section
                                            • Enhanced myometrial vascularity (EMV): Descriptive term for low-resistance waveforms of variable velocity spanning full myometrial thickness
                                              • Common, seen in 50% of asymptomatic patients on postpartum day 3
                                              • Seen with RPOC, gestational trophoblastic disease, placental site subinvolution, arteriovenous malformation

                                          IMAGING

                                          • General Features

                                            • Ultrasonographic Findings

                                              • MR Findings

                                                DIFFERENTIAL DIAGNOSIS

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Demographics

                                                      • Natural History & Prognosis

                                                        • Treatment

                                                          DIAGNOSTIC CHECKLIST

                                                          • Consider

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Wang SS et al: Imaging of postpartum/peripartum complications. Radiol Clin North Am. 58(2):431-43, 2020
                                                              2. Groszmann YS et al: Diagnosis and management of patients with enhanced myometrial vascularity associated with retained products of conception. Ultrasound Obstet Gynecol. 52(3):396-9, 2018
                                                              3. Iraha Y et al: Multimodality imaging in secondary postpartum or postabortion hemorrhage: retained products of conception and related conditions. Jpn J Radiol. 36(1):12-22, 2018
                                                              4. Phillips CH et al: First-trimester emergencies: a radiologist's perspective. Emerg Radiol. 25(1):61-72, 2018
                                                              5. Kamaya A et al: Clinical and imaging predictors of management in retained products of conception. Abdom Radiol (NY). 41(12):2429-34, 2016
                                                              6. Kamaya A et al: Variable color Doppler sonographic appearances of retained products of conception: radiologic-pathologic correlation. Abdom Imaging. 40(7):2683-9, 2015
                                                              7. Ben-Ami I et al: A comparison of reproductive outcomes following hysteroscopic management versus dilatation and curettage of retained products of conception. Int J Gynaecol Obstet. 127(1):86-9, 2014
                                                              8. Smorgick N et al: Hysteroscopic management of retained products of conception: meta-analysis and literature review. Eur J Obstet Gynecol Reprod Biol. 173:19-22, 2014
                                                              9. Atri M et al: Best predictors of grayscale ultrasound combined with color Doppler in the diagnosis of retained products of conception. J Clin Ultrasound. 39(3):122-7, 2011
                                                              10. Kitahara T et al: Management of retained products of conception with marked vascularity. J Obstet Gynaecol Res. 37(5):458-64, 2011