Correlação entre suspeita ultrassonográfica de aborto incompleto e achado histológico de restos ovulares

Abstract

Purpose: Determine the correlation between sonographic suspicion of incomplete abortion and the histopathological finding of chorionic villi. Methods: Cross-sectional and retrospective study. We included all patients with sonographic suspicion of incomplete abortion admitted for uterine curettage in the Maternity School of Federal University of Rio de Janeiro from January 4, 2011 to March 07, 2012, whose material obtained was sent for histopathological examination. We studied the following variables: age, number of pregnancies, abortions, signs and symptoms, sonographic findings, results of histopathological examination. The project was approved by the Ethics Committee of the institution. Data were analyzed in EPIINFO version 6.0 (program STATCALC). To analyze the association between variables we used the Fisher exact test and statistical significance was assumed when p <0.05. Results: Of the 251 cases of abortion occurred during the period, 58 were included in the sample. The mean age of patients was 26.41 years. Thirty-three (56.90%) were early abortions, 11 (18.96%) late and 14 (24.12%) reported gestational age unknown. Most (38, 65.52%) was multigesta and of these, 16 (42.10%) reported a history of previous abortion. Vaginal bleeding was the most common complaint (100% of cases) followed by cramps (62.07%). There was histological confirmation of retained products of conception in 36 (62.07%) of 58 cases with suspected ultrasound. Cramps was the only variable associated with the presence of ovular remains (p = 0.03). There was no significant difference in endometrial thickness between patients with or without chorionic villi in histopathology. The color Doppler was used in two patients (3.45%). In both met vasculature suspected of retained products of conception and its presence was confirmed in the histological examination. The average time elapsed between ultrasound and uterine curettage was 3 hours and 11 minutes in patients with villi in histopathology and 4 hours and 36 minutes for presenting decidua (p = 0.08). Conclusions: Incomplete abortion was confirmed in 62.07% of cases with sonographic suspicion and the presence of cramps was the only variable associated with this diagnosis. With respect to endometrial thickness, not found cutoff to define the presence of chorionic villi in the histopathological examination. There is no significant difference in the average time elapsed between ultrasound and uterine curettage among patients who had chorionic villi and decidua in histopathology.