Saba Sohail, Mohsin Hussain, Ghazala Shahzad, Abid Ali Sahito, Sasui Memon, Asma Jatoi.
The Diagnostic Accuracy of Ultrasound in Retained Products of Conception in Postpartum Period by Using Histopathology as the Gold Standard.
Annals Punjab Med Coll Jan ;14(3):277-80.

Background: Retained product of conception (RPOC) has been the commonest factor involved in secondary post-partum hemorrhage. Ultrasound is a valuable diagnostic method for the diagnosis of PPH patients and is much more reliable than clinical presentation for the RPOC diagnosis alone. Objective: To determine the diagnostic accuracy of ultrasound in detection of retained products of conception in postpartum period in clinically suspected patients taking histopathology as gold standard. Study Design: Cross-sectional study. Settings: Radiology Department, Civil Hospital, Karachi Pakistan. Duration: From 5th February 2017 to 4th August 2017. Methodology: Total 135 patients with clinical suspicion of retained product of conception were included. Sonography was performed. D & C was performed and specimen sent for histopathology. The diagnostic accuracy of ultrasound was established regarding specificity, sensitivity, NPV, PPV, against histopathology. Post stratification chi square test was applied and p-value ≤0.05 was considered as significant. Results: The mean age of patients was 31.84±7.91 years. Mean duration of symptoms was 3.48±1.44 weeks. By ultrasound, 64.4% were diagnosed retained products of conception and by histopathology 54.8% were diagnosed. There were 65 true positive patients and 39 true negative patients. Specificity, Sensitivity, NPV, PPV, and accuracy were 63.9%, 87.8%, 81.2%, 74.7%, and 77% respectively. Conclusion: Ultrasonography was observed as a reliable diagnostic tool showed accuracy rate of 77.0% with 87.8% sensitivity and 63.9% specificity, in the diagnosis of retained products of conception (RPOC).

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