Clinical outcome analysis of persistent simple intrauterine anechoic areas
Objective To analyze the clinical outcomes of persistent simple intrauterine anechoic areas.Methods A total of 3 759 patients with persistent simple intrauterine anechoic areas were retrospectively collected from our hospital between March 2015 and May 2021.Additionally,one case was included where a patient was transferred to our hospital for further treatment due to poorβ-HCG decline after curettage at another hospital for a simple intrauterine anechoic area.In total,3760 cases were analyzed to examine the clinical characteristics and special clinical outcomes of all patients.Results Among the 3 760 patients,the clinical outcome for 3745 patients was missed abortion,while the clinical outcome for 15 patients was non-missed abortion.Among the patients with non-missed abortion,11 had a decline in blood β-HCG of more than 50％ on the first day after surgery,and their pathological reports showed"hydatidiform mole".In 3 patients,blood β-HCG levels increased rather than decreased on the first day after surgery,with an increase of less than 15％.Their pathological reports all showed"decidual tissue".Since there is a delay in obtaining the pathological reports,timely pelvic ultrasound examinations were conducted,which indicated ectopic pregnancy,and laparoscopic surgery was promptly performed.One patient transferred from another hospital had a small decrease in blood β-HCG on the 7th day after surgery.Reexamination at our hospital found the blood β-HCG level to be 8754 mIU/mL.Pelvic ultrasound suggested an interstitial pregnancy,and laparoscopy with left interstitial incision and embryo extraction was performed.Conclusion In clinical work,ultrasound indicates that most patients with persistent simple intrauterine anechoic areas present as missed abortion.However,there remains a possibility of hydatidiform mole and ectopic pregnancy in some patients.Therefore,blood β-HCG should be closely monitored before and after curettage,pathological examination should be emphasized,and pelvic ultrasound should be rechecked if necessary to prevent missed or misdiagnosed cases of molar pregnancy and ectopic pregnancy.
万方数据
维普
