Comparative efficacy of trans abdominal and trans vaginal sonography augmented with color doppler and biomarkers in diagnosis of retained products of conception

Javeria Ijaz; Rushmail Aftab; Noor Fatima; Gul zaib Khan; Zoya Younas; Maryam Arshad

Comparative efficacy of trans abdominal and trans vaginal sonography augmented with color doppler and biomarkers in diagnosis of retained products of conception

Date

2026

Authors

Javeria Ijaz

Rushmail Aftab

Noor Fatima

Gul zaib Khan

Zoya Younas

Maryam Arshad

Publisher

UMT, Lahore

Abstract

Retained products of conception (RPOC) are a frequently occurring cause of post abortion and post miscarriage hemorrhage and can cause severe maternal morbidity unless correctly diagnosed. The ultrasound is the most popular form of imaging which will be employed in assessment and the diagnostic potential of Transabdominal Ultrasound (TAS) and Transvaginal Ultrasound (TVS) in combination with Color Doppler and clinical biomarkers is among the mostimportant issues of study. In this cross-sectional study, 116 suspected RPOC patients, who had the history of clinical history, pattern of bleeding, and miscarriages documented in the past, were included. TAS and TVS were determined in all the patients with examination of intrauterine vascularity by checking color Doppler and b-hCG was determined by serum level. The mean age of the participants was 30.81 +- 6.99 years and mean gestational age at which termination was done was 13.78 +- 4.47 weeks. Confirmed RPC existed in 44.8 and the most frequent symptom of presentation was heavy bleeding (40.5). TAS was suspicious of RPIC on ultrasound in 22.4 percent of cases versus TVS which was suspicious in 44.8 percent cases. The results with statistically significant association were found between findings of TAS and TVS (kh2 = 41.244, p < 0.001), and the TVS showed the identification of further cases not identified on TAS. TAS was found to be having a moderate positive relationship with the final diagnosis (r = 0.596, p = 0.001), whereas TVS was found to be having a total agreement with the final diagnosis (r = 1.000, p = 0.001). The serum levels of b-hCG of patients with confirmed RPOC (2128.88 +- 922.53 IU/L) were significantly more than in the patients without RPOC (121.95 + 73.73 IU/L), and the difference was statistically significant (t = 15.647, p < 0.001). TVS augmented with color Doppler performed better than TAS in terms of diagnostic ability and nearest correlation with the final diagnosis. The levels of serum b-hCG were also significantly high in confirmed cases and could become a helpful supportive biomarker. The application of TVS, color Doppler, and serum b-hCG seems to be the most consistent diagnosis of retained products of conception.