A young adult female had history of D & C done during early pregnancy. At present she has:
* Bulky uterus
* Retained products of conception
* Possible early partial gestational sac
* Large subchorionic hematoma
Ultrasound images shown below:
Prognosis:
The prognosis for this patient depends on the size and location of the retained products of conception. As the products are small and confined to the uterine cavity, they may be able to be removed with medication or a minor procedure. However, it must be noted that if the products are large or located in the uterine wall, they may require a more invasive procedure, such as a D&C or hysterectomy. This does not appear to be the case here.
What is the management approach?
The management of this patient will depend on the findings of the ultrasound and the patient's clinical presentation. If the patient is experiencing heavy bleeding or cramping, she may need to be admitted to the hospital for observation and treatment. If the products of conception are small and confined to the uterine cavity, she may be able to be treated with medication or a minor procedure in the outpatient setting.
Some possible complications of this condition:
* Infection
* Hemorrhage
* Infertility
Some additional information about the ultrasound imaging findings:
* A bulky uterus is one that is larger than expected for the patient's gestational age. This can be caused by retained products of conception, a pregnancy, or other conditions.
* Retained products of conception are tissue that remains in the uterus after a miscarriage or abortion. This can cause bleeding, pain, and infection.
* A large subchorionic hematoma is a collection of blood that occurs between the chorion and the uterine wall. This can cause bleeding and pain.
Images in this case are courtesy of Dr Golam
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