Analysis Of The Clinical Characteristics Of Retained Products Of Conception

ObjectiveThis study was designed to investigate the clinical features of Retained products of conception,including ultrasound characteristics,factors affecting preoperative and intraoperative bleeding,and choice of treatment methods to provide data support for clinical diagnosis and treatment. MethodsRetrospective analysis of 78 cases of clinically diagnosed clinical cases of RPOC from October 2006 to February 2019.The data were reviewed and collected.The patients were all treated with hysteroscopic surgery.The pathological diagnosis was all placenta.Villi and / or decidua tissue,of which 24 cases of placental villus,accounting for 30.8%(24/78),suggesting 41 cases of placental villus with decidual tissue,accounting for 52.6%(41/78);There were 13 organizers suggesting decidua,accounting for 16.7%(13/78).Statistical analysis was performed using SPSS22.0software.The measurement data was represented by x+s,and the count data was represented by n(%).Data analysis was performed using the T-test and chi-square test,and P < 0.05 was considered statistically significant. Results1.RPOC's chief complaint analysis: the main complaint was vaginal bleeding in 46 cases,accounting for 59.0%(46/78);the main complaint was 5 cases of amenorrhea,accounting for 6.4%(5/78);only ultrasound showed abnormality in 27 cases,accounting for 34.6%(27/78)).2.Ultrasound blood flow grading analysis of RPOC: All cases were classified according to ultrasonic blood flow grading.The results were: 17 cases of grade 0,accounting for 21.8%(17/78);14 cases of grade 1 accounted for 14.9%(14/78);11cases of grade 2,accounting for 14.1%(11/78);13 cases of grade 3,accounting for16.7%(13/78);23 cases of grade 4,accounting for 29.5%(23/78).According to the above classification and statistics,all cases were divided into group A and group B,group A was non-abnormal blood flow group,including ultrasound blood flow classification was grade 0,grade 1 and grade 2,a total of 42 cases,accounting for53.8%(42/78);Group B was abnormal blood flow group,including ultrasound blood flow classification was grade 3 and grade 4,a total of 36 cases,accounting for 46.2%(36/78).The statistical results showed that there was a difference between the abnormal blood flow of the ultrasound and the gestational age of the termination of pregnancy,the nature of the intrauterine mass,the presence or absence of implantation and the pathological results.The difference was statistically significant(P=0.002,P=0.029,P=0.015).,P = 0.015),and the termination of pregnancy form,residue residence time,blood HCG status,previous curettage,ultrasound residue size and intrauterine residue position were not statistically significant.3.Factors affecting preoperative RPOC bleeding: The history of 78 patients admitted to hospital was counted.According to the blood hemoglobin value of admission,the patients were divided into anemia and non-anemia.Among them,18 cases were anemia,accounting for 23.08%(18/78).There were 60 cases of non-anemic cases,accounting for 76.9%(60/78).Separate the gestational weeks,terminate the pregnancy form,the residence time of the residue in the uterine cavity,whether it is a curettage,blood HCG,ultrasound,including intrauterine mass traits,residue size,ultrasound or not In the implantation situation,the positions of the residual contents in the uterine cavity were compared respectively.The statistical results showed that the serous HCG and the size of the ultrasound group were related to the preoperative RPOC bleeding volume(P=0.005,P=0.01),and other factors and the preoperative blood loss of RPOC.None were significantly related.4.Factors affecting the amount of bleeding during RPOC: the intraoperative blood loss was 400ml(more than 400 ml,not more than 400ml),of which 5 cases exceeded 400 ml,accounting for 6.41%(5/78);The number of cases not exceeding400 ml was 73 cases,accounting for 93.59%(73/78).Statistical analysis showed thatserous HCG and ultrasound photon size were related to intraoperative RPOC bleeding(P=0.0,P=0.0),while termination of gestational weeks,termination of pregnancy,residue in intrauterine residence time,serous HCG,there was no significant difference in the previous curettage,the position of the residual cavity in the uterus,the nature of the intrauterine mass,and the implantation.5.Hysteroscopic single clearance rate and blood flow changes: 75 cases of residual tissue were removed by hysteroscopic surgery,accounting for 96.2%(75/78);3 cases were not single removal,accounting for 3.8%(3/78).Postoperative follow-up to preoperative ultrasound showed abnormal blood flow in 19 cases,postoperative blood flow disappeared in 18 cases,and one case of ultrasound was still abnormal,which residual tissue were not cleared completely.Conclusions1.Vaginal bleeding is the main clinical manifestation of residual tissue in uterine cavity.2.The ultrasound's results of RPOC can be expressed as abnormal blood flow signal,but the abnormal blood flow signal does not affect the preoperative and intraoperative blood loss of RPOC.3.The size of the residual tissue of the uterine cavity and the serous HCG value are factors affecting the amount of preoperative and intraoperative blood loss.4.Preoperative diagnosis of patients with abnormal blood flow signals is unclear,and hysteroscopic surgery may be a means of assisting RPOC diagnosis and treatment.