Work

Diagnostic dilemma in post-abortion intrauterine retention: endometrial polyps mimicking retained products of conception

Year: 2025

Type: article

Abstract: Objective This retrospective study investigated the characteristics of endometrial polyps identified during incomplete abortion management and evaluated differences between these polyps and retained products of conception. Methods Patients with intrauterine retention within 4 months after abortion were enrolled in this study between January 2019 and December 2024. Twenty-six patients with pathologically confirmed endometrial polyps were included in the case group, while fifty-two patients with confirmed retained products of conception (RPOC) comprised the control group. The groups were matched in a 1:2 ratio based on gestational age (±1 week). Results Twenty-six study group patients were included; 69.2% (18/26) were nulliparous. Abortions occurred in gestational age of 6–14 weeks. No polyps were identified prior to subsequent surgical intervention. Hysteroscopy was performed on 24 women. In hysteroscopic cases, no endometrial polyp was larger than 2 centimeters in size. Compared with control group, the study group had lower gravidity (1 [0–3] vs. 2 [0–8], p = 0.025) and lower serum β-hCG levels (3.67 [0–799.1] mIU/ml vs. 21.08 [0–901.2] mIU/ml, p = 0.004). Ultrasonography indicated a lower rate of abundant blood flow (7.7% vs. 46.2%, p = 0.001) and smaller intrauterine volume (1.93 ± 2.55 cm 3 vs. 5.42 ± 4.94 cm 3 , p = 0.001) in the study group. Additionally, the study group had a significantly longer interval from pregnancy termination to subsequent surgical intervention (51.5 ± 31.7 days vs. 38.2 ± 14.9 days, p < 0.001). Conclusions Endometrial polyps should be considered in stable women after abortion with intrauterine retention present with low blood flow on doppler, low β-hCG levels, and prolonged retention, especially in women with lower gravidity. Hysteroscopy is recommended for accurate diagnosis and proper management, preventing unnecessary treatment for presumed retained products of conception.

Source: Frontiers in Global Women s Health

DOI: 10.3389/fgwh.2025.1666642

Authors: Wei-Fang Wu, Shi-Han Yan, Hai-Hua Xu, Chao-Bin Liu, Xi Xie, Shun-He Lin

Institution: Fujian Medical University

Language: English

Topic: Gynecological conditions and treatments

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,077